Chakravarti Sujata, Al-Qaqaa Yasir, Faulkner Meghan, Bhatla Puneet, Argilla Michael, Ramirez Michelle
Division of Pediatric Cardiology, New York University School of Medicine , NY, USA.
Division of Pediatric Critical Care, Department of Pediatrics, New York University School of Medicine , NY, USA.
Pediatr Rep. 2016 Jun 23;8(2):6596. doi: 10.4081/pr.2016.6596. eCollection 2016 Jun 15.
Fluid overload (FO) is a common complication for pediatric patients in the intensive care unit. When conventional therapy fails, hemodialysis or peritoneal dialysis is classically used for fluid removal. Unfortunately, these therapies are often associated with cardiovascular or respiratory instability. Ultrafiltration, using devices such as the Aquadex™ system (Baxter Healthcare, Deerfield, IL, USA), is an effective tool for fluid removal in adult patients with congestive heart failure. As compared to hemodialysis, ultrafiltration can be performed using smaller catheters, and the extracorporeal volume and minimal blood flow rates are lower. In addition, there is no associated abdominal distension as is seen in peritoneal dialysis. Consequently, ultrafiltration may be better tolerated in critically ill pediatric patients. We present three cases of challenging pediatric patients with FO in the setting of congenital heart disease in whom ultrafiltration using the Aquadex™ system was successfully utilized for fluid removal while cardiorespiratory stability was maintained.
液体超负荷（FO）是重症监护病房儿科患者常见的并发症。当传统治疗无效时，经典的做法是使用血液透析或腹膜透析来清除液体。不幸的是，这些治疗常常与心血管或呼吸不稳定相关。使用如Aquadex™系统（美国伊利诺伊州迪尔菲尔德市百特医疗保健公司）等设备进行超滤，是成年充血性心力衰竭患者清除液体的有效工具。与血液透析相比，超滤可使用更细的导管进行，体外循环血量和最低血流速率更低。此外，不会出现腹膜透析时所见的腹胀。因此，危重症儿科患者对超滤的耐受性可能更好。我们报告3例患有先天性心脏病且伴有FO的具有挑战性的儿科患者，在维持心肺稳定的同时，成功使用Aquadex™系统进行超滤清除液体。
