ABSTRACT 158

Abstract

Background and aims: Multi Organ Dysfunction Syndrome (MODS) with Fluid Overload(F.O) is a common occurrence in Pediatric Intensive Care Unit(PICU) in sick children. Unfortunately scanty literature is available in developing countries. Aims: To emphasize the utility of CRRT in managing critically ill children with MODS. Methods: Medical records of children required CRRT in PICU from September 2010 to October 2013 were retrospectively analysed to obtain data on demographic factors, CRRT prescription, circuit life span, hemodynamic steability while on CRRT, anticoagulants, feasibility and complications. Results: During the study period 20 children required CRRT (male-15). Age group ranged from 13 months to 16 years. 11 patients had primary diagnosis of sepsis with MODS, while 5 had severe Dengue with F.O. At initiation of CRRT, all patients were receiving mechanical ventilation, inotropic support (inotropic index>15) and had oligoanuria with MODS. Total of 24 CRRT sessions amounting to 778.3hours were given. CVVHDF was preferred in all patients. Heparin as anticoagulant was used in all except 5 patients. Timing from admission in ICU to initiation of CRRT varied between 13 to 432 hours. Though survival rate was 40.5%, Ventilation settings and inotropic requirements were reduced in 83% and renal functions improved in 85%. Hypokalemia, Hypophosphatemia, Hypomagnesemia, Hypocalcemia were observed in 75%, 55%, 40%, 10% patients respectively. Conclusions: This shows CRRT had beneficial effects on respiratory and renal status of critically ill children with MODS and F.O. There is a need for prospective study with large sample size to assess mortality benefits in children in developing countries.