Seattle Children's, Seattle, WA, USA.
University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
Pediatr Nephrol. 2020 Dec;35(12):2345-2352. doi: 10.1007/s00467-020-04664-7. Epub 2020 Jun 30.
Continuous kidney replacement therapy (CKRT) is a common modality for treatment of severe acute kidney injury (AKI) in children. Adult technologies routinely utilized to provide this therapy have a large extracorporeal volume. The Prismaflex™ HF20 filter set has a relatively low extracorporeal blood volume of 60 mL, which provides technological benefit for smaller children compared with current filter sets available in the USA.
We conducted a multicenter, open-label single group study to evaluate whether the Prismaflex™ HF20 filter set delivers efficacious and safe CKRT to support patients with AKI, fluid overload, or both in pediatric patients weighing ≥ 8 to 20 kg.
Twenty-three patients were enrolled between April 24, 2016 and April 8, 2018. The mean reduction in blood urea nitrogen from baseline to 24 h was 58.12 ± 20.08% (95% CI, - 68.45 and - 47.79 (p = 0.0008)). Median cumulative normalized effluent rate at 24 h was 60.8 mL/kg/h (25.9, 83.7). None of the patients participating in the study suffered a serious adverse event; thus, no obvious safety concerns were noted.
We suggest that the Prismaflex HF20™ filter set used in conjunction with the Prismaflex™ System Software Version 7.10 or 7.20 is a suitable alternative to larger filter sets for use in pediatric patients weighing less than 20 kg. Graphical abstract.
连续肾脏替代疗法(CKRT)是治疗儿童严重急性肾损伤(AKI)的常用方法。用于提供这种治疗的成人技术常规具有较大的体外体积。Prismaflex™ HF20 过滤器组具有相对较低的 60 毫升体外血液量,与目前在美国可用的过滤器组相比,为较小的儿童提供了技术优势。
我们进行了一项多中心、开放标签的单组研究,以评估 Prismaflex™ HF20 过滤器组是否能有效且安全地提供 CKRT,以支持体重≥8 至 20 公斤的 AKI、液体超负荷或两者兼有的儿科患者。
2016 年 4 月 24 日至 2018 年 4 月 8 日期间,共有 23 名患者入组。与基线相比,24 小时时血尿素氮的平均降低率为 58.12±20.08%(95%可信区间,-68.45 至-47.79(p=0.0008))。24 小时时累积标准化洗脱率中位数为 60.8 毫升/公斤/小时(25.9,83.7)。参与研究的患者均未发生严重不良事件;因此,未发现明显的安全问题。
我们建议,与 Prismaflex™ 系统软件版本 7.10 或 7.20 一起使用的 Prismaflex HF20™ 过滤器组是小于 20 公斤的儿科患者使用较大过滤器组的合适替代方案。