Journal article
Renal replacement therapies for infants and children in the ICU
Current opinion in pediatrics, Vol.32(3), pp.360-366
06/2020
DOI: 10.1097/MOP.0000000000000894
PMCID: PMC7310588
PMID: 32332327
Abstract
Pediatric acute kidney injury (AKI) in critically ill patients is associated with increased morbidity and mortality. Emerging data support that the incidence of pediatric AKI in the ICU is rising. For children with severe AKI, renal replacement therapy (RRT) can provide a lifesaving supportive therapy. The optimal timing to deliver and modality by which to deliver RRT remain a point of discussion within pediatric (and adult) literature. This review discusses the use of RRT for pediatric patients in the ICU. We discuss the most recent evidence-based methods for RRT with a focus on continuous RRT.\nThe feasibility of dialyzing the smallest infants and more medically complex children in the ICU is dependent on the advancements in dialysis access and circuit technology. At present, data indicate that upward of 27% of children in the ICU develop AKI and 6% require RRT. Newer dialysis modalities including prolonged intermittent hemodialysis and continuous flow peritoneal dialysis as well as newer dialysis technologies such as the smaller volume circuits (e.g., Cardio-Renal Pediatric Dialysis Emergency Machine, Newcastle Infant Dialysis and Ultrafiltration System) have made the provision of dialysis safer and more effective for pediatric patients of a variety of sizes.\nRenal replacement in the ICU requires a multidisciplinary team approach that is facilitated by a pediatric nephrologist in conjunction with intensivists and skilled nursing staff. Although mortality rates for children on dialysis remain high, outcomes are improving with the support of the multidisciplinary team and dialysis technology advancements.
Details
- Title: Subtitle
- Renal replacement therapies for infants and children in the ICU
- Creators
- Keia R Sanderson - Department of Medicine-Nephrology, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaLyndsay A Harshman - Division of Pediatric Nephrology, Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Current opinion in pediatrics, Vol.32(3), pp.360-366
- DOI
- 10.1097/MOP.0000000000000894
- PMID
- 32332327
- PMCID
- PMC7310588
- NLM abbreviation
- Curr Opin Pediatr
- ISSN
- 1040-8703
- eISSN
- 1531-698X
- Publisher
- United States
- Grant note
- K23 DK110443 / NIDDK NIH HHS\nKL2 TR002490 / NCATS NIH HHS
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology
- Record Identifier
- 9984070835402771
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