Acute Kidney Injury in In Paediatrics

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Maintain Renal Perfusion AVOID Dopamine: • Low-dose dopamine in children has not been effective at improving outcomes either. Filler G. Paediatr Drugs 2001; 3:783–792 . • May cause transient improvement of urine output, but • Does not decrease AKI incidence, need for RRT or improve AKI outcomes. • Is associated with increased myocardial oxygen demand. • Negative immunomodulatory effects • P. Dennen et al, Crit Care Med 2010 Vol. 38, No. 1 • Adult studies of low/“renal”dose - dopamine have failed to show benefit and actually may even be harmful Venkataraman R, Kellum JA:; Chest 2007; 131: 300–308 . Bellomo R, et al: Lancet 2000; 356: 2139–2143 .
Maintain Renal Perfusion Choice of Fluid in AKI: • From both the SAFE and SOAP studies • Neither demonstrated clear benefit in colloid over crystalloid infusions. • There have been no published studies relating type of fluid used in paediatric resuscitation and AKI incidence or outcomes. • Basu RK, et al; Pediatr Crit Care Med 2011; 12: 339–347
Page 1 and 2: Acute Kidney Injury In Paediatrics
Page 3 and 4: What is AKI? • A sudden deteriora
Page 5 and 6: Long Term Outcomes • At 3 to 5-yr
Page 7 and 8: RIFLE vs AKIN
Page 9 and 10: pRIFLE CLASS Change in eCCl Urine O
Page 11 and 12: Biomarkers • The pRIFLE, RIFLE an
Page 13 and 14: Biomarkers • The quest to find ea
Page 15 and 16: NGAL • Urine NGAL > 50ug/ml predi
Page 17 and 18: IL-18 • Induced in the proximal r
Page 19 and 20: Management • Prevention of AKI is
Page 21 and 22: Ways to Prevent Contrast-Induced Ne
Page 23 and 24: Ways to Prevent Contrast-Induced
Page 25 and 26: Common Nephrotoxins in ICU EXOGENOU
Page 27 and 28: Management General principles of
Page 29 and 30: Maintain Renal Perfusion Vasopresso
Page 31: Maintain Renal Perfusion • Renal
Page 35 and 36: Cumulative Fluid Overload • The p
Page 37 and 38: Nutritional Support • Nutrition i
Page 39 and 40: Renal Replacement Therapy • Curre
Page 41 and 42: Timing of RRT • In paediatrics, t
Page 43 and 44: Differences between adult and • P
Page 45 and 46: Differences between adult and • P
Page 47 and 48: With CRRT • We must continually w
Page 49 and 50: Conclusions • Management of AKI i
Page 51 and 52: Conclusion • However, paediatric

Acute Kidney Injury in In Paediatrics

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