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Review
. 2012;34(2):138-48.
doi: 10.1159/000342129. Epub 2012 Oct 24.

Pediatric renal replacement therapy in the intensive care unit

Brian C Bridges  1 , David J Askenazi, Jessimene Smith, Stuart L Goldstein
Affiliations
Review

Pediatric renal replacement therapy in the intensive care unit

Brian C Bridges et al. Blood Purif. 2012.

Abstract

Renal replacement therapy (RRT) is used in a wide variety of pediatric populations. In this article, we will review the advantages and disadvantages of the different RRT modalities and the technical aspects of providing pediatric RRT. In addition, we will review the use of RRT with extracorporeal membrane oxygenation, the use of continuous RRT in the critically ill child with acute kidney injury and fluid overload, and the use of RRT for the removal of toxins and treatment of inborn errors of metabolism.

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Figures

Figure 1
Figure 1. A detailed step-by-step protocol which mixes PRBCs and sodium bicarbonate using a Y-connector
Figure 2
Figure 2. Schematic of an in-line hemofilter added to an ECMO circuit
Blood from the oxygenator is drained via a three-way stopcock and pigtail tubing (A) to the hemofilter. An alternate connection (B) can be made. Hemofilter circuit blood returns to circuit tubing (C) and a three-way stopcock to the venous bladder. Hemofilter ultrafiltrate is drained by an automated pump (D) and collected and measured with an urometer. An IV pump (E) can be used to supply filter replacement fluids. An electronic flow probe (F) measures actual postmembrane flow for calculation of hemofilter ‘runoff’. Reprinted with permission from Hoover et al. [62].
Figure 3
Figure 3. Schematic of the inclusion of a CRRT device into an ECMO circuit with a centrifugal pump
Reprinted with permission from Santiago et al. [63].
See this image and copyright information in PMC

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