López-Herce Cid J, Carrillo Alvarez A, Panadero Carlavilla E, Sánchez Sánchez C, Moral Torrero R, Bustinza Arriourtúa A
Sección de Cuidados Intensivos Pediatricos, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid.
An Esp Pediatr. 1998 Jul;49(1):39-45.
The objective of this study was to analyze the efficacy of continuous veno-venous renal replacement therapies in neonates and children.
We analyzed 10 episodes of acute renal failure in 9 patients, between 7 days and 2 years of age and weighing between 2.9 and 13 kg, treated with continuous veno-venous renal replacement therapies (hemofiltration or hemodiafiltration) by using a BSM-32-IC (Hospal) monitor and two types of hemofilters, Miniflow of 0.04 m2 (Hospal) and FH22 of 0.2 m2 (Gambro).
We used a blood flow between 15 and 40 ml/min and obtained an ultrafiltration rate of 190 +/- 61 ml/hour. The mean life of the hemofilters was 16 +/- 14 hours, with the duration of the technique between 5 and 58 hours. In three episodes the technique was ended because of normalization of renal function. All patients tolerated continuous renal replacement therapies without important secondary effects (one patient had moderate ischemia of the leg because of erroneous arterial catheterization, 3 patients had electrolyte alterations. 1 patient had hypothermia and 5 patients needed platelet transfusions). Seven patients died because of shock and multiple organ failure which was not related to the technique.
Continuous veno-venous renal replacement therapies are useful in the treatment of critically ill children. Veno-venous techniques can be used in term neonate and infants.
本研究的目的是分析连续性静脉 - 静脉肾脏替代疗法在新生儿和儿童中的疗效。
我们分析了9例患者的10次急性肾衰竭发作，年龄在7天至2岁之间，体重在2.9至13千克之间，采用BSM - 32 - IC（Hospal）监护仪及两种血液滤过器（0.04平方米的Miniflow（Hospal）和0.2平方米的FH22（Gambro））进行连续性静脉 - 静脉肾脏替代疗法（血液滤过或血液透析滤过）治疗。
我们使用的血流量为15至40毫升/分钟，超滤率为190±61毫升/小时。血液滤过器的平均使用寿命为16±14小时，该技术持续时间为5至58小时。在3次发作中，该技术因肾功能恢复正常而结束。所有患者均耐受连续性肾脏替代疗法，未出现严重的副作用（1例患者因动脉插管错误出现腿部中度缺血，3例患者出现电解质紊乱，1例患者体温过低，5例患者需要输注血小板）。7例患者因休克和多器官功能衰竭死亡，与该技术无关。
连续性静脉 - 静脉肾脏替代疗法对危重症儿童的治疗有用。静脉 - 静脉技术可用于足月儿和婴儿。
