keyword
https://read.qxmd.com/read/37975941/continuous-renal-replacement-therapy-in-neonates-and-children-what-does-the-pediatrician-need-to-know-an-overview-from-the-critical-care-nephrology-section-of-the-european-society-of-paediatric-and%C3%A2-neonatal-intensive-care-espnic
#21
REVIEW
Gerard Cortina, Marco Daverio, Demet Demirkol, Rahul Chanchlani, Akash Deep
Continuous renal replacement therapy (CRRT) is the preferred method for renal support in critically ill and hemodynamically unstable children in the pediatric intensive care unit (PICU) as it allows for gentle removal of fluids and solutes. The most frequent indications for CRRT include acute kidney injury (AKI) and fluid overload (FO) as well as non-renal indications such as removal of toxic metabolites in acute liver failure, inborn errors of metabolism, and intoxications and removal of inflammatory mediators in sepsis...
February 2024: European Journal of Pediatrics
https://read.qxmd.com/read/37930418/programs-and-processes-for-advancing-pediatric-acute-kidney-support-therapy-in-hospitalized-and-critically-ill-children-a-report-from-the-26th-acute-disease-quality-initiative-adqi-consensus-conference
#22
JOURNAL ARTICLE
Tara M Neumayr, Benan Bayrakci, Rahul Chanchlani, Akash Deep, Jolyn Morgan, Ayse Akcan Arikan, Rajit K Basu, Stuart L Goldstein, David J Askenazi
Pediatric acute kidney support therapy (paKST) programs aim to reliably provide safe, effective, and timely extracorporeal supportive care for acutely and critically ill pediatric patients with acute kidney injury (AKI), fluid and electrolyte derangements, and/or toxin accumulation with a goal of improving both hospital-based and lifelong outcomes. Little is known about optimal ways to configure paKST teams and programs, pediatric-specific aspects of delivering high-quality paKST, strategies for transitioning from acute continuous modes of paKST to facilitate rehabilitation, or providing effective short- and long-term follow-up...
March 2024: Pediatric Nephrology
https://read.qxmd.com/read/37880024/liver-transplantation-for-acute-liver-failure-due-to-yellow-phosphorus-poisoning-a-comprehensive-review
#23
JOURNAL ARTICLE
Hirak Pahari, Amruth Raj, Amey Sonavane, Ambreen Sawant, Deepak Kumar Gupta, Amit Gharat, Vikram Raut
Yellow phosphorus or metal phosphide (YP-MP) rodenticide poisoning has been a known cause of acute liver failure (ALF) in many countries of Asia and North and South America over the last decade. It is a highly toxic compound and is a well-known cause of intentional or accidental poisoning in both adults and children. In lower doses, it causes gastrointestinal symptoms and mild hepatic injury, and patients may spontaneously recover. In higher doses, hepatic necrosis and fatty infiltration may cause significant injury and may even lead to ALF, characterized by hepatic encephalopathy, coagulopathy, and lactic acidosis...
October 23, 2023: Transplantation Proceedings
https://read.qxmd.com/read/37871460/managing-the-kidney-the-role-of-continuous-renal-replacement-therapy-in-neonatal-and-pediatric-ecmo
#24
REVIEW
Abhinav Totapally, Brian C Bridges, David T Selewski, Elizabeth E Zivick
Extracorporeal membrane oxygenation (ECMO) represents a lifesaving therapy utilized in in the most critically ill neonates and children with reversible cardiopulmonary failure. As a result of the severity of their critical illness these patients are among the highest risk populations for developing acute kidney injury (AKI) and disorders of fluid balance including the pathologic state of fluid overload (FO). In multiple studies AKI has been shown to occur commonly in 60-80% children treated with ECMO and is associated with adverse outcomes...
August 2023: Seminars in Pediatric Surgery
https://read.qxmd.com/read/37837221/estimating-risk-of-prolonged-mechanical-ventilation-after-liver-transplantation-in-children-prove-alt-score
#25
JOURNAL ARTICLE
Muhammad Umair M Mian, Curtis E Kennedy, Jorge A Coss-Bu, Ramsha Javaid, Buria Naeem, Fong Wilson Lam, Thomas Fogarty, Ayse A Arikan, Trung C Nguyen, Dalia Bashir, Manpreet Virk, Sanjiv Harpavat, Nhu Thao Nguyen Galvan, Abbas A Rana, John A Goss, Daniel H Leung, Moreshwar S Desai
BACKGROUND: Children at high risk for prolonged mechanical ventilation (PMV) after liver transplantation (LT) need to be identified early to optimize pulmonary support, allocate resources, and improve surgical outcomes. We aimed to develop and validate a metric that can estimate risk for Prolonged Ventilation After LT (PROVE-ALT). METHODS: We identified preoperative risk factors for PMV by univariable analysis in a retrospective cohort of pediatric LT recipients between 2011 and 2017 (n = 205; derivation cohort)...
October 13, 2023: Pediatric Transplantation
https://read.qxmd.com/read/37733114/effect-of-intravenous-immunoglobulin-on-the-outcome-of-children-with-septic-shock-in-a-picu-a-retrospective-cohort-study
#26
JOURNAL ARTICLE
Haixin Huang, Jian Chen, Hongxing Dang, Chengjun Liu, Junming Huo, Yue-Qiang Fu
UNLABELLED: The therapeutic efficacy of intravenous immuneglobulin (IVIG) on children with septic shock remains uncertain. Therefore, we endeavored to investigate the impact of administering intravenous immunoglobulin (IVIG) in the pediatric intensive care unit (PICU) on patient with septic shock. We retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2017 to December 2021 in a tertiary pediatric hospital. The main outcome was in-hospital mortality...
September 21, 2023: European Journal of Pediatrics
https://read.qxmd.com/read/37725911/expanding-the-spectrum-of-extracorporeal-strategies-in-small-infants-with-hyperammonemia
#27
REVIEW
Giovanni Ceschia, Mattia Parolin, Germana Longo, Claudio Ronco, Enrico Vidal
Hyperammonemia is a life-threatening condition mainly due to the neurotoxicity of ammonia. Ammonia scavengers may be insufficient, and extracorporeal treatment may be required. Continuous treatments are preferred, and a high-dose continuous renal replacement therapy (CRRT) must be prescribed to ensure a fast ammonia depletion. Many of the children with hyperammonemia are newborns, with lower blood volume than older children. The majority of the CRRT systems are adult-based, with large extracorporeal priming volumes and inadequate UF control...
2023: Blood Purification
https://read.qxmd.com/read/37669450/the-effect-of-therapeutic-hypothermia-on-prognosis-in-patients-receiving-continuous-renal-replacement-therapy
#28
JOURNAL ARTICLE
Gultac Evren, Neslihan Zengin
Continuous renal replacement therapy (CRRT) is a commonly used therapeutic modality in the pediatric intensive care unit (PICU) for the treatment of severe acute kidney injury, as well as for addressing metabolic abnormalities, fluid-electrolyte imbalances, and acid-base disorders. According to reports, therapeutic hypothermia treatment has demonstrated the ability to decrease cellular metabolism, oxygen consumption, formation of free radicals, cell death, and inflammatory signals. The study encompassed all individuals who underwent CRRT at both Manisa City Hospital and Manisa Celal Bayar University Hospital throughout the period from February 2021 to November 2022...
September 5, 2023: Therapeutic Hypothermia and Temperature Management
https://read.qxmd.com/read/37607519/hemolytic-uremic-syndrome-induced-acute-kidney-injury-treated-via-immunomodulation-with-the-selective-cytopheretic-device
#29
JOURNAL ARTICLE
H Rhodes Hambrick, Kara Short, David Askenazi, Kelli Krallman, Christopher Pino, Lenar Yessayan, Angela Westover, H David Humes, Stuart L Goldstein
INTRODUCTION: Shiga-toxin associated-hemolytic uremic syndrome (STEC-HUS) is a severe cause of acute kidney injury (AKI) in children. Although most children recover, about 5% die and 30% develop chronic renal morbidity. HUS pathophysiology includes activated neutrophils damaging vascular endothelial cells. Therapeutic immunomodulation of activated neutrophils may alter the progression of disease. We present 3 pediatric patients treated with the selective cytopheretic device (SCD). METHODS: We describe a 12 y...
August 22, 2023: Blood Purification
https://read.qxmd.com/read/37547524/worldwide-exploration-of-renal-replacement-outcomes-collaborative-in-kidney-disease-we-rock
#30
JOURNAL ARTICLE
Shina Menon, Kelli A Krallman, Ayse A Arikan, Dana Y Fuhrman, Stephen M Gorga, Theresa Mottes, Nicholas Ollberding, Zaccaria Ricci, Natalja L Stanski, David T Selewski, Danielle E Soranno, Michael Zappitelli, Huaiyu Zang, Katja M Gist
INTRODUCTION: Continuous renal replacement therapy (CRRT) is used for the symptomatic management of acute kidney injury (AKI) and fluid overload (FO). Contemporary reports on pediatric CRRT are small and single center in design. Large international studies evaluating CRRT practice and outcomes are lacking. Herein, we describe the design of a multinational collaborative. METHODS: The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) is an international collaborative of pediatric specialists whose mission is to improve short- and long-term outcomes of children treated with CRRT...
August 2023: KI Reports
https://read.qxmd.com/read/37476891/clinical-characteristics-and-outcomes-of-continuous-renal-replacement-therapy-performed-on-younger-children-weighing-up-to-10-kg
#31
JOURNAL ARTICLE
Emrah Gün, Anar Gurbanov, Özlem Saritaş Nakip, Ahmet Yöntem, Ayşen Durak Aslan, Edin Botan, Fevzi Kahveci, Serhan Özcan, Ebru Azapağası, Serhat Emeksiz, Mutlu Uysal Yazıcı, Selman Kesici, Özden Özgür Horoz, Ömer Erdeve, Benan Bayrakçı, Rıza Dinçer Yıldızdaş, Tanil Kendirli
BACKGROUND: This study aimed to investigate the clinical features, modality, complications, and effecting factors on the survival of children weighing up to 10 kg who received continuous renal replacement therapy (CRRT). METHODS: This study was a retrospective observational study conducted in five pediatric intensive care units in tertiary hospitals in Turkey between January 2015 and December 2019. RESULTS: One hundred and forty-one children who underwent CRRT were enrolled in the study...
June 2023: Turkish Journal of Medical Sciences
https://read.qxmd.com/read/37461591/revisiting-post-icu-admission-fluid-balance-across-pediatric-sepsis-mortality-risk-strata-a-secondary-analyses-from-a-prospective-observational-cohort-study
#32
Mihir R Atreya, Natalie Z Cvijanovich, Julie C Fitzgerald, Scott L Weiss, Michael T Bigham, Parag N Jain, Kamal Abulebda, Riad Lutfi, Jeffrey Nowak, Neal J Thomas, Torrey Baines, Michael Quasney, Bereketeab Haileselassie, Rashmi Sahay, Bin Zhang, Matthew Alder, Natalja Stanski, Stuart Goldstein
Introduction : Post-ICU admission cumulative positive fluid balance (PFB) is associated with increased mortality among critically ill patients. We sought to test whether this risk varied across biomarker-based risk strata upon adjusting for illness severity, presence of severe acute kidney injury (AKI), and use of renal replacement therapy (CRRT) in pediatric septic shock. Design : Ongoing multi-center prospective observational cohort. Setting : Thirteen pediatric ICUs in the United States (2003-2023). Patients : Six hundred and eighty-one children with septic shock...
June 28, 2023: Research Square
https://read.qxmd.com/read/37400882/prognostic-and-predictive-value-of-endothelial-dysfunction-biomarkers-in-sepsis-associated-acute-kidney-injury-risk-stratified-analysis-from-a-prospective-observational-cohort-of-pediatric-septic-shock
#33
JOURNAL ARTICLE
Mihir R Atreya, Natalie Z Cvijanovich, Julie C Fitzgerald, Scott L Weiss, Michael T Bigham, Parag N Jain, Adam J Schwarz, Riad Lutfi, Jeffrey Nowak, Geoffrey L Allen, Neal J Thomas, Jocelyn R Grunwell, Torrey Baines, Michael Quasney, Bereketeab Haileselassie, Matthew N Alder, Stuart L Goldstein, Natalja L Stanski
BACKGROUND: Sepsis-associated acute kidney injury (SA-AKI) is associated with high morbidity, with no current therapies available beyond continuous renal replacement therapy (CRRT). Systemic inflammation and endothelial dysfunction are key drivers of SA-AKI. We sought to measure differences between endothelial dysfunction markers among children with and without SA-AKI, test whether this association varied across inflammatory biomarker-based risk strata, and develop prediction models to identify those at highest risk of SA-AKI...
July 3, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/37397150/novel-blood-product-transfusion-regimen-to-prevent-clotting-and-citrate-accumulation-during-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation-in-children
#34
JOURNAL ARTICLE
Yuelin Sun, Dong Li, Ke Bai, Feng Xu, Chengjun Liu, Hongxing Dang
OBJECTIVE: Introduce a novel protocol to prevent clotting and citrate accumulation (CA) from blood product transfusion (BPT) during continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in children. METHODS: We prospectively compared fresh frozen plasma (FFP) and platelet transfusions between the two BPT protocols, direct transfusion protocol (DTP) and partial replacement of citrate transfusion protocol (PRCTP), in terms of the risks of clotting, citric accumulation (CA), and hypocalcemia...
2023: Frontiers in Pediatrics
https://read.qxmd.com/read/37378151/method-to-alleviate-dilutional-coagulopathy-caused-by-continuous-renal-replacement-therapy-introduction-in-a-low-birth-weight-neonate-a-case-report
#35
Satoshi Nakajima, Kentaro Ide, Emily Knaup, Shotaro Matsumoto, Satoshi Nakagawa
Continuous renal replacement therapy (CRRT) in neonates and children has recently been used to treat hyperammonemia and metabolic disorders. However, CRRT introduction in low-birth-weight neonates is still a challenge due to vascular access limitations, bleeding complications, and a lack of neonatal-specific devices. We present the case of a low-birth-weight neonate whose severe coagulopathy due to CRRT introduction with a red cell concentration-primed circuit was alleviated by priming the new circuit with blood from the current circuit...
May 2023: Curēus
https://read.qxmd.com/read/37359983/perspectives-of-pediatric-nephrologists-intensivists-and-nurses-regarding-aki-management-and-expected-outcomes
#36
JOURNAL ARTICLE
Adrian Che, David D'Arienzo, Allison Dart, Cherry Mammen, Susan Samuel, Todd Alexander, Catherine Morgan, Tom Blydt-Hansen, Patricia Fontela, Gonzalo Garcia Guerra, Rahul Chanchlani, Stella Wang, Vedran Cockovski, Natasha Jawa, Jasmine Lee, Sophia Nunes, Stephanie Reynaud, Michael Zappitelli
BACKGROUND: Acute kidney injury (AKI) in critically ill children is associated with increased risk for short- and long-term adverse outcomes. Currently, there is no systematic follow-up for children who develop AKI in intensive care unit (ICU). OBJECTIVE: This study aimed to assess variation regarding management, perceived importance, and follow-up of AKI in the ICU setting within and between healthcare professional (HCP) groups. DESIGN: Anonymous, cross-sectional, web-based surveys were administered nationally to Canadian pediatric nephrologists, pediatric intensive care unit (PICU) physicians, and PICU nurses, via professional listservs...
2023: Canadian Journal of Kidney Health and Disease
https://read.qxmd.com/read/37310173/combined-therapeutic-plasma-exchange-and-continuous-renal-replacement-therapy-in-children-with-dengue-associated-acute-liver-failure-and-shock-syndrome-single-center-cohort-from-vietnam
#37
JOURNAL ARTICLE
Luan Thanh Vo, Viet Chau Do, Tung Huu Trinh, Thien Vu, Thanh Tat Nguyen
OBJECTIVES: Pediatric acute liver failure (PALF) is a fatal complication in patients with severe dengue. To date, clinical data on the combination of therapeutic plasma exchange (TPE) and continuous renal replacement therapy (CRRT) for managing dengue-associated PALF concomitant with shock syndrome are limited. DESIGN: Retrospective cohort study (January 2013 to June 2022). PATIENTS: Thirty-four children. SETTING: PICU of tertiary Children's Hospital No...
June 13, 2023: Pediatric Critical Care Medicine
https://read.qxmd.com/read/37266815/pharmacokinetics-in-critically-ill-children-with-acute-kidney-injury
#38
REVIEW
Manan Raina, Amani Ashraf, Anvitha Soundararajan, Anusree Krishna Mandal, Sidharth Kumar Sethi
Acute kidney injury (AKI) is a commonly encountered comorbidity in critically ill children. The coexistence of AKI disturbs drug pharmacokinetics and pharmacodynamics, leading to clinically significant consequences. This can complicate an already critical clinical scenario by causing potential underdosing or overdosing giving way to possible therapeutic failures and adverse reactions. Current available studies offer little guidance to help maneuver such complex dosing regimens and decision-making in pediatric patients as most of them are done on heterogeneous groups of adult populations...
July 2023: Paediatric Drugs
https://read.qxmd.com/read/37233776/safety-and-efficacy-of-continuous-renal-replacement-therapy-for-children-less-than-10%C3%A2-kg-using-standard-adult-machines
#39
JOURNAL ARTICLE
Manju Kedarnath, Emma C Alexander, Akash Deep
UNLABELLED: Continuous Renal Replacement Therapy (CRRT) machines are used off-label in patients less than 20 kg. Infant and neonates-dedicated CRRT machines are making their way into current practice, but these machines are available only in select centres. This study assesses the safety and efficacy of CRRT using adult CRRT machines in children ≤ 10 kg and to determines the factors affecting the circuit life in these children. DESIGN: Retrospective cohort study of children ≤ 10 kg who received CRRT (January 2010-January 2018) at a PICU in a tertiary care centre in London, UK...
August 2023: European Journal of Pediatrics
https://read.qxmd.com/read/37139253/evaluation-of-dosing-regimens-of-vancomycin-and-aminoglycosides-in-pediatric-patients-on-continuous-renal-replacement-therapy
#40
JOURNAL ARTICLE
Mark L Vestal, Beiyu Liu, Travis S Heath
OBJECTIVE: To determine the optimal empiric dosing regimen to achieve therapeutic serum concentrations of vancomycin and aminoglycosides in pediatric patients who are receiving continuous renal replacement therapy (CRRT). METHODS: This retrospective study investigated pediatric patients (<18 years old) who received at least one dose of an aminoglycoside and/or vancomycin while on CRRT and who had at least one serum concentration assessed during the study period...
2023: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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