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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
predominant indication for RST during
ECMO in this cohort, with AKI most
prominent in non-US centers and those
performing primary cardiac support.
Nephrology is the primary author of
RST prescriptions worldwide but most
markedly in US centers. Further work by
this group hopes to elucidate more
specific details regarding FO and AKI in
this population and the association with
outcomes.
5. Continuous Veno-Venous
Haemofiltration (CVVH) In
Infants in PICU Using The
Proprietary Prismaflex ® Device
And HF20 Haemofilter And
Circuit
Glenda Fleming, Barry Wilkins, David
Harper
Children's Hospital at Westmead
CVVH in infants is difficult because
there is little available technology
allowing low extracorporeal circuit
volume. We started a programme using
the Prismaflex® hemofiltration machine
and HF2® filter/circuit (extracorporeal
volume 6 mL) in infants.
14 infants, age 1 week to 19 months
(3.5-11 kg), were treated over 3 months
<strong>from</strong> June 29 to December 211, 1 for
acute renal failure and 4 for inborn
errors of metabolism. We monitored
negative fluid balance; fall in plasma
urea/creatinine/ammonia/organic acids,
circuit life, circuit pressures. Vascular
access was through peripheral
cannulation in 12 patients via an ECMO
circuit in two patients. 112 treatment
sessions, were performed over 99
patient-days (range 1-25 sessions, mean
8, and 1-24 days of treatment, mean 6.7
days per patient). Heparin was used as
anticoagulant in all patients. We also
changed two patients to citrate. Blood
flow was 3-8.3 ml/kg/min (2 ml/min
minimum). CVVH with prefilter
replacement fluid was standard. Effluent
was 2% of blood flow. Negative or
neutral fluid balance was always
achieved and plasma creatinine, urea,
ammonia and organic acid values fell to
steady-state within 3 hours. Access
pressure, filter pressure, venous return
pressure and trans-membrane pressure
were always within acceptable ranges.
Reasons for changing circuits included
routine at 72 hours, other interventions,
clotting in the access pressure pod (31
cases), rising TMP (2 cases), scale
malfunction, extended power failure and
cracked filter (1 case each). One adverse
clinical event of and intra cerebral
haemorrhage occurred during treatment
with CVVH. 7 patients died <strong>from</strong> their
primary disease.
The Prismaflex HF2 circuit is
efficacious in infants as small as 3.5 kg.
Filter life is comparable to reports in
older children and adults.
6. Continuous Veno-Venous
Haemofiltration (CVVH) In
Infants and Children In PICU
Using The Proprietary
Prismaflex® Device And ST60
Haemofilter And Circuit
Glenda Fleming, Barry Wilkins, David
Harper
Children's Hospital at Westmead
Continuous Renal Replacement Therapy
in infants and small children is difficult
because there is little available
technology allowing low extracorporeal
circuit volume. We started a program
using the Prismaflex® hemofiltration
machine and ST6® filter/circuit
(extracorporeal volume 93 mL) in
infants and small children. 1 infants and
children, aged 9 months to 8 years (8-28
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