Zero Mortality of Continuous Veno-venous Hemodiafiltration with PMMA Hemofilter after Pediatric Cardiac Surgery
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概要
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Objective: Continuous veno-venous hemodiafiltration (CVVH) is used as one of the modalities of continuous renal replacement therapy (CRRT) in pediatric intensive units. The aim of our study was to investigate the use of CVVH in small children with acute renal failure (ARF) after cardiac surgery.Patient and Methods: Between June 2005 and June 2008, 7 patients who required dialysis after pediatric cardiac surgery without ECMO underwent CVVH with polymethylmethacrylate membrane (PMMA) treatment. The definition of ARF was based on a 100% rise in serum creatinine (Cr) concentration, oliguria. On the other hand, PMMA-CVVH was weaned in patients with satisfactory urine output, stable biochemical markers of renal function and adequate fluid balance.Results: All patients treated with PMMA-CVVH alone (4 boys, 3 girls) had a median age of 36 months and a median body weight of 11kg. The averaged established time from cardiac operation to CVVH was 2.6 days. There was a significant decrease in the post-filter compared with pre-filter levels of BUN, Cr, potassium concentration. There were no significant changes in systolic blood pressure, lactate level and CRP; however, it was unnecessary for all patients to use epinephrine.Conclusions: Continuous veno-venous hemodiafiltration with PMMA-CVVH without ECMO achieved a surprisingly Zero mortality.
- 2011-08-01
著者
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Miyamoto Takashi
Department Of Cardiology Nihon University Surugadai Hospital
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Ishii Yoichiro
Department Of Pediatrics And Developmental Medicine Gunma University Graduate School
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Yoshimoto Akihiro
Department Of Haematology-oncology And Respiratory Medicine Cellular Transplantation Biology Kanazaw
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KOBAYASHI Tomio
Department of Cardiology, Gunma Children's Medical Center
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Tatsu Kazuhito
Department Of Cardiovascular Surgery Gunma Children's Medical Center
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Miyamoto Takashi
Department Of Cardiovascular Surgery Gunma Children's Medical Center
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IKEDA Kentaro
Department of Pediatric Cardiology, Gunma Children's Medical Center
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Ikeda Kentaro
Department Of Pediatric Cardiology Gunma Children's Medical Center
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Yoshimoto Akihiro
Department Of Cardiovascular Surgery Gunma Children's Medical Center
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Ishii Yoichiro
Department Of Pediatric Cardiology Gunma Children's Medical Center
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Kobayashi Tomio
Department Of Pediatric Cardiology Gunma Children's Medical Center
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Yoshimoto Akihiro
Department Of Applied Biochemistry Faculty Of Applied Biological Science Hiroshima University
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