Management of fluid balance in continuous renal replacement therapy: Technical evaluation in the pediatric setting

Zaccaria Ricci, S. Morelli, V. Vitale, L. Di Chiara, D. Cruz, S. Picardo

Research output: Contribution to journalArticlepeer-review

Abstract

Fluid overload control and fluid balance management represent very important factors in critically ill children requiring renal replacement therapy. A relatively high fluid volume administration in children and neonates is often necessary to deliver adequate amounts of blood derivatives, vasopressors, antibiotics, and parenteral nutrition. Fluid balance errors during pediatric continuous renal replacement therapy (CRRT) might significantly impact therapy delivery and have been described as potentially lethal. The aim of this study was to evaluate the accuracy of delivered vs. prescribed net ultrafiltration (UF) during CRRT applied to 2 neonates and 2 small children, either as dialytic treatment alone or during extracorporeal membrane oxygenation (ECMO). In accordance with an Acute Dialysis Quality Initiative workgroup statement, net UF was defined as the "overall amount of fluid extracted from the patient in a given time". Mean prescribed net UF was 18.5 ml/h (SD=6.7) during neonatal treatments and 70.3 ml/h (SD=22.5) during CRRT in small children. Daily net UF ranged from 200 mL to about 600 mL in the 2 neonates and from 1,200 to 1800 mL in the 2 children. The percentage error of delivered net UF ranged from -1.6% to 5.8% of the prescribed level. The mean error of the ECMO/CRRT patients was 3.024 ml/h vs. 0.45 m/h for the CRRT patients (p

Original languageEnglish
Pages (from-to)896-901
Number of pages6
JournalInternational Journal of Artificial Organs
Volume30
Issue number10
Publication statusPublished - Oct 2007

Keywords

  • Accuracy
  • Continuous renal replacement therapy
  • Fluid balance
  • Fluid overload
  • Pediatric cardiac surgery

ASJC Scopus subject areas

  • Biophysics

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