[Continuous arteriovenous hemofiltration in the newborn]. 1988

H Hilt, and J Goecke, and H J Gramm
Klinik für Anaesthesiologie und operative Intensivmedizin, Klinikum Steglitz der Freien Universität Berlin.

Acute renal failure (ARF) in newborns and infants is a serious postoperative complication. Peritoneal dialysis is considered the treatment of choice, but is often impossible postoperatively. In adult patients or older children, continuous arteriovenous hemofiltration (CAVH) has been established for 10 years. In 1985, Ronco published case reports on four newborn infants treated with CAVH using a specially designed hemofilter. In between, a few more case reports have been published. We report a case of postoperative septic ARF in an 8-week-old girl with a body weight of 4000 g. We used the Minifilter (Amicon Corp.) connected to a femoral arterial Shaldon catheter and initially a central venous line, later a subclavian Shaldon catheter. Intermittent hemodialysis without ultrafiltration was performed as well. With ultrafiltration rates of 2 to 24 ml/h, mean 12.8 ml/h, we achieved an impressive loss of weight and the pulmonary function improved. The baby died on the 5th day of CAVH treatment of septic multiorgan failure. Even though the small patient did not survive, we demonstrated the feasibility of the method in newborns. CAVH is recommended for overhydrated babies with oligoanuric ARF, but it is not sufficient as a substitute for dialysis in these patients.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D005260 Female Females
D006440 Hemofiltration Extracorporeal ULTRAFILTRATION technique without HEMODIALYSIS for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. Arteriovenous Hemofiltration,Venovenous Hemofiltration,Arteriovenous Hemofiltrations,Hemofiltration, Arteriovenous,Hemofiltration, Venovenous,Hemofiltrations,Venovenous Hemofiltrations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D058186 Acute Kidney Injury Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions. Acute Kidney Failure,Acute Kidney Insufficiency,Acute Renal Failure,Acute Renal Injury,Acute Renal Insufficiency,Kidney Failure, Acute,Kidney Insufficiency, Acute,Renal Failure, Acute,Renal Insufficiency, Acute,Acute Kidney Failures,Acute Kidney Injuries,Acute Kidney Insufficiencies,Acute Renal Failures,Acute Renal Injuries,Acute Renal Insufficiencies,Kidney Failures, Acute,Kidney Injuries, Acute,Kidney Injury, Acute,Kidney Insufficiencies, Acute,Renal Failures, Acute,Renal Injuries, Acute,Renal Injury, Acute,Renal Insufficiencies, Acute

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