Zobel G, Ring E, Zobel V
Department of Paediatrics, University of Graz, Austria.
Pediatr Nephrol. 1989 Apr;3(2):140-3. doi: 10.1007/BF00852895.
Five different arteriovenous renal replacement systems were used to treat 23 critically ill oliguric or anuric children. Slow continuous ultrafiltration (SCU) was carried out for 8 patient days, continuous arteriovenous haemofiltration (CAVH) for 40, suction-supported CAVH for 56, continuous or intermittent arteriovenous haemodiafiltration (AVHDF) for 3, and continuous arteriovenous haemodialysis (CAVHD) for 24 days. SCU allowed excellent control of fluid overload in 4 patients within 47 +/- 17 h. Urea clearances ranged from 5.6 +/- 2.1 ml/min per m2 (spontaneous CAVH) to 15.3 +/- 3.7 ml/min per m2 (CAVHD) and enabled good control of azotaemia. Ultrafiltration rates of the different filters ranged from 1.6 +/- 0.3 to 11.5 +/- 2.4 ml/min per m2. The only serious complication was a femoral artery thrombosis in a 1.5-year-old boy. Minor side-effects were local bleeding at the entrance site of the arterial catheter and transient hypotension during suction-supported CAVH. Of 23 patients, 8 died because of progressive multiple organ system failure, a mortality of 35%.
使用五种不同的动静脉肾脏替代系统治疗23名患有严重少尿或无尿的危重症儿童。缓慢持续超滤（SCU）进行了8个患者日，连续性动静脉血液滤过（CAVH）进行了40个患者日，负压辅助CAVH进行了56个患者日，连续性或间歇性动静脉血液透析滤过（AVHDF）进行了3个患者日，连续性动静脉血液透析（CAVHD）进行了24个患者日。SCU在47±17小时内使4例患者的液体超负荷得到了良好控制。尿素清除率范围为每平方米5.6±2.1毫升/分钟（自发性CAVH）至每平方米15.3±3.7毫升/分钟（CAVHD），并能很好地控制氮质血症。不同滤器的超滤率范围为每平方米1.6±0.3至11.5±2.4毫升/分钟。唯一严重的并发症是一名1.5岁男孩发生股动脉血栓形成。轻微的副作用是动脉导管入口处局部出血以及负压辅助CAVH期间的短暂性低血压。23例患者中，8例因进行性多器官系统衰竭死亡，死亡率为35%。
