ABSTRACTS from 16th International COnference on ... - CRRT Online

G31
CRRT in the Newborn: Principles and Practical Issues
Jordan M. Symons MD
8:00-9:30
Thursday, February 16
Educational Objectives:
Faculty:
David Askenazi
Jordan Symons
1. Describe the epidemiology of acute kidney injury in neonates and the indications for CRRT in the newborn
2. Discuss the special technical considerations for neonatal CRRT
3. Understand the unique issues associated with performing CRRT for newborn patients
Content Description:
For many years any form of dialysis support was considered too difficult for neonates; for those centers that
would provide renal replacement, peritoneal dialysis was considered the only viable modality. In fact, CRRT
was first used for neonates almost thirty years ago and its use has expanded since that time.
Performing CRRT for newborn patients presents unique challenges. There are significant technical barriers to
performing CRRT in neonates and risks may be magnified when devices and materials designed for use in adults
are adapted to the care of very small patients. This session will discuss the epidemiology of acute kidney injury
in the newborn, indications for CRRT, technical and pragmatic approaches to the procedure with emphasis on the
differences <strong>from</strong> therapy as used in older children and adults, and some distinctive clinical circumstances for the
use of CRRT. We look forward to an interactive session where members of the audience will share their own
experiences, allowing all participants to gain further knowledge.
Suggested Reading:
1. Askenazi DJ et al. Baseline values of candidate urine acute kidney injury biomarkers vary by gestational age
in premature infants. Pediatric Research (2011) 70:302-6.
2. Askenazi DJ et al. Urine biomarkers predict acute kidney injury and mortality in very low birth weight
infants. J Pediatr (2011) 159:907-12.
3. Askenazi DJ et al. Acute kidney injury and renal replacement therapy independently predict mortality in
neonatal and pediatric noncardiac patients on extracorporeal membrane oxygenation. Pediatr Crit Care Med
(2011) 12:e1-e6.
4. Brophy PD et al. AN-69 membrane reactions are pH-dependent and preventable. Am J Kid Dis (2001)
38:173-8.
5. McBryde KD et al. Renal replacement therapy in the treatment of confirmed or suspected inborn errors of
metabolism. J Pediatr (2006)
6. Pasko DA et al. Pre dialysis of blood prime in continuous hemodialysis normalizes pH and electrolytes.
Pediatr Nephrol (2003) 18:1177-83.
7. Picca S et al. Extracorporeal dialysis in neonatal hyperammonemia: modalities and prognostic indicators.
Pediatr Nephrol (2001) 16:862-7.
8. Schaefer F et al. Dialysis in neonates with inborn errors of metabolism. Nephrol Dial Transplant (1999)
14:2815-8.
9. Symons JM et al. Continuous renal replacement therapy in children up to 10 kg. Am J Kid Dis (2003)
18:833-7.
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