Abstract P-309: SAFE AND EFFECTIVE USE OF HF20 HAEMOFILTER IN 33 INFANTS 1.8–20 KG FOR UREA, AMMONIUM, WATER AND METABOLITE REMOVAL USING THE PRISMAFLEX DEVICE

Abstract

Aims & Objectives: The PrismaFlex® (Baxter) system with the 0.2 m2 surface area Polyarylethersulfone HF20® set, with 60 ml priming volume, has been used in our Paediatric Intensive Care Unit (PICU) since 2009. We aimed to review its use retrospectively for indications, effectiveness and safety. Methods Review of electronic medical records including fluid balance, sequential measurements of urea, potassium, creatinine, ammonium and phosphate, and circuit life and reasons for ceasing circuits. Results 33 patients, 52% male, had one episode each of renal replacement therapy. Patient data and indications are shown in the tables. 6.5F or 8F double-lumen catheters were used, and one via ECMO circuit. Blood flow was 3–4 ml/kg/min except minimum 20 ml/min according to policy when blood flow was 3–11 ml/kg/min. 188 circuits were used (1–40, mean 5.7 per patient). Circuit life was 0.75–79 hours. 62 circuits failed after <8 hours. Failure was for circuit clotting, high trans-membrane pressure (TMP), or access pressure, or return pressure. 53 circuits were ceased electively. Calculated urea clearance was 29–236 ml/kg/hr (median 43); the higher values were for ammonium or metabolite removal. In all cases plasma urea, potassium, phosphate or ammonium or metabolites fell with half-times of 20 hours or less in most cases. First 24-hour circuit balance was –1686 to +134 ml. Ten patients died from their underlying disease. No complications occurred which affected patient care or outcome.Conclusions The HF20® filter set with the PrismaFlex® machine has been used effectively and safely in infants as small as 1.8 kg.