Continuous Renal Replacement Therapy (CRRT) for Nonrenal Indications among Critically Ill Children with Malignancy
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作者:
Hui, Wun Fung
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Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R ChinaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Hui, Wun Fung
[1
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Hon, Kam Lun
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Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R ChinaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Hon, Kam Lun
[1
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Leung, Alexander K. C.
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机构:
Univ Calgary, Dept Paediat, Calgary, AB T2M 0H5, Canada
Alberta Childrens Prov Gen Hosp, Calgary, AB T2M 0H5, CanadaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Leung, Alexander K. C.
[2
,3
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Leung, Karen Ka Yan
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Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R ChinaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Leung, Karen Ka Yan
[1
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Ku, Shu Wing
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Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R ChinaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Ku, Shu Wing
[1
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Cheng, Frankie W. T.
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Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R ChinaHong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
Cheng, Frankie W. T.
[1
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机构:
[1] Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[2] Univ Calgary, Dept Paediat, Calgary, AB T2M 0H5, Canada
[3] Alberta Childrens Prov Gen Hosp, Calgary, AB T2M 0H5, Canada
The role of continuous renal replacement therapy (CRRT) has been expanding beyond support for acute kidney injury (AKI) in recent years. Children with malignancy are particularly at risk of developing conditions that may require CRRT. We reported three children with malignancy who received CRRT for non-AKI indications. Patient 1 was a 17-year-old teenage girl who developed refractory type B lactic acidosis due to relapse of acute lymphoblastic leukemia (ALL). Her peak lactate level was 18 mmol/L, and the lowest pH and bicarbonate level was 7.13 and 6.0 mmol/L, respectively. She received three sessions of high-volume hemodiafiltration to bring down the lactate level. Patient 2 was a 15-year-old male with T-cell ALL who developed cytokine storm requiring mechanical ventilatory and high-dose inotropic support due to necrotizing enterocolitis complicated by pneumoperitoneum and Klebsiella pneumoniae septicemia. He received two sessions of hemoperfusion using a specific filter capable of endotoxin absorption and cytokine removal and was successfully weaned off all inotropes after the treatment. Patient 3 was an 8-year-old boy who received bone marrow transplantation and developed worsening hyperbilirubinemia and deteriorating liver function. He received a session of single-pass albumin dialysis for bilirubin removal prior to liver biopsy. Except for mild electrolyte disturbances, no major CRRT complication was encountered. Our report demonstrated that CRRT is an effective and safe procedure for a wide spectrum of nonrenal conditions among children with oncological diagnoses in the pediatric intensive care unit. However, the optimal dose, regime, timing of initiation, and monitoring target for these indications remain to be determined.
机构:
Ankara Univ, Dept Pediat, Fac Med, Ankara, TurkeyAnkara Univ, Dept Pediat, Fac Med, Ankara, Turkey
Tuncer, Hatice Erkol
Ekim, Mesiha
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Ankara Univ, Dept Pediat, Fac Med, Ankara, Turkey
Ankara Univ, Dept Pediat Nephrol, Fac Med, Ankara, TurkeyAnkara Univ, Dept Pediat, Fac Med, Ankara, Turkey
Ekim, Mesiha
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机构:
Okulu, Emel
Atasay, Begum
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机构:
Ankara Univ, Dept Pediat, Fac Med, Ankara, Turkey
Ankara Univ, Dept Neonatol, Fac Med, Ankara, TurkeyAnkara Univ, Dept Pediat, Fac Med, Ankara, Turkey
机构:
LIVERPOOL HOSP, DEPT ANAESTHESIA INTENS CARE & CORONARY CARE, SYDNEY, AUSTRALIALIVERPOOL HOSP, DEPT ANAESTHESIA INTENS CARE & CORONARY CARE, SYDNEY, AUSTRALIA
DICKSON, DM
HILLMAN, KM
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LIVERPOOL HOSP, DEPT ANAESTHESIA INTENS CARE & CORONARY CARE, SYDNEY, AUSTRALIALIVERPOOL HOSP, DEPT ANAESTHESIA INTENS CARE & CORONARY CARE, SYDNEY, AUSTRALIA
机构:
Istanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, TurkiyeIstanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, Turkiye
Atis, Seyma Koksal
Duyu, Muhterem
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Istanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Pediat Intens Care Unit, Istanbul, TurkiyeIstanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, Turkiye
Duyu, Muhterem
Karakaya, Zeynep
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Istanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, TurkiyeIstanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, Turkiye
Karakaya, Zeynep
Yilmaz, Alev
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机构:
Istanbul Univ, Dept Pediat, Div Pediat Nephrol, Fac Med, Istanbul, TurkiyeIstanbul Goztepe Prof Dr Suleyman Yalcin City Hosp, Dept Pediat, Istanbul, Turkiye