Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Continuous renal replacement therapy in neonates weighing less than 3 kg

  • Sohn, Young-Bae (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Paik, Kyung-Hoon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Hee-Yeon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Su-Jin (Department of Pediatrics, Myongji Hospital, Kwandong University College of Medicine) ;
  • Park, Sung-Won (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Eun-Sun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chang, Yun-Sil (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Won-Soon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Yoon-Ho (Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jin, Dong-Kyu (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2011.11.01
  • 심사 : 2012.03.23
  • 발행 : 2012.08.15
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초록

Purpose: Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for supporting critically ill pediatric patients. However, a few studies present have reported CRRT use and outcome in neonates weighing less than 3 kg. The aim of this study is to describe the clinical application, outcome, and complications of CRRT in small neonates. Methods: A retrospective review was performed in 8 neonatal patients who underwent at least 24 hours of pumped venovenous CRRT at the Samsung Medical Center in Seoul, Korea, between March 2007 and July 2010. Data, including demographic characteristics, diagnosis, vital signs, medications, laboratory, and CRRT parameters were recorded. Results: The data of 8 patients were analyzed. At the initiation of CRRT, the median age was 5 days (corrected age, $38^{+2}$ weeks to 23 days), and the median body weight was 2.73 kg (range, 2.60 to 2.98 kg). Sixty-two patient-days of therapy were reviewed; the median time for CRRT in each patient was 7.8 days (range, 1 to 37 days). Adverse events included electrolyte disturbances, catheter-related complications, and CRRT-related hypotension. The mean circuit functional survival was $13.9{\pm}8.6$ hours. Overall, 4 patients (50%) survived; the other 4 patients, who developed multiorgan dysfunction syndrome, died. Conclusion: The complications of CRRT in newborns are relatively high. However, the results of this study suggest that venovenous CRRT is feasible and effective in neonates weighing less than 3 kg under elaborate supportive care. Furthermore, for using potential benefit of CRRT in neonates, efforts are required for prolonging filter survival.

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참고문헌

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피인용 문헌

  1. Continuous Renal Replacement Therapy in Neonates vol.20, pp.1, 2012, https://doi.org/10.5385/nm.2013.20.1.12
  2. Citrate anticoagulation for continuous renal replacement therapy in small children vol.29, pp.3, 2012, https://doi.org/10.1007/s00467-013-2690-6
  3. 신생아와 영아의 지속적 신대체 요법 vol.18, pp.1, 2012, https://doi.org/10.3339/jkspn.2014.18.1.13
  4. Continuous Renal Replacement Therapy in the Neonatal Intensive Care Unit: A Single-Center Study vol.21, pp.4, 2012, https://doi.org/10.5385/nm.2014.21.4.244
  5. CVVHD treatment with CARPEDIEM: small solute clearance at different blood and dialysate flows with three different surface area filter configurations vol.31, pp.10, 2012, https://doi.org/10.1007/s00467-016-3397-2
  6. Renal replacement therapy in neonates with an inborn error of metabolism vol.62, pp.2, 2012, https://doi.org/10.3345/kjp.2018.07143
  7. Choice of Catheter Size for Infants in Continuous Renal Replacement Therapy : Bigger Is Not Always Better* vol.20, pp.3, 2012, https://doi.org/10.1097/pcc.0000000000001825
  8. Short-term results of continuous venovenous haemodiafiltration versus peritoneal dialysis in 40 neonates with inborn errors of metabolism vol.178, pp.6, 2012, https://doi.org/10.1007/s00431-019-03361-4
  9. A Case Series: Continuous Kidney Replacement Therapy in Neonates With Low Body Weight vol.9, pp.None, 2012, https://doi.org/10.3389/fped.2021.769220
  10. Review: Neonatal dialysis is technically feasible but ethical and global issues need to be addressed vol.110, pp.3, 2012, https://doi.org/10.1111/apa.15539