Continuous Venovenous Hemofiltration in Children Less Than or Equal to 10 kg: A Single-Center Experience

Abstract

The aim of this study was to review the data from patients with a body weight less than or equal to 10 kg who required continuous venovenous hemofiltration, to assess the feasibility and problems associated with continuous venovenous hemofiltration in this population and compare the results with the current literature. Retrospective study design. PICU in a single tertiary pediatric referral center. Children less than or equal to 10 kg who received continuous venovenous hemofiltration between January 2008 and July 2014 were included in the study. Clinical data from these children were analyzed, and the differences between survivors and nonsurvivors were evaluated and compared with results from current literature. In a subgroup analysis of children less than or equal to 5 kg compared with children between 5 and 10 kg, the survival rate, indications for continuous venovenous hemofiltration, and continuous venovenous hemofiltration characteristics were assessed. In total, 71 continuous renal replacement therapy episodes in 70 children were included in the study. Children in our cohort had a survival rate of 57.7% (41/71). Survivors had less frequent need for vasopressor support prior to continuous venovenous hemofiltration, lower oxygen requirement and percent fluid overload at continuous venovenous hemofiltration initiation. Survival rate was not significantly different in children less than or equal to 5 kg compared with 5-10 kg. However, in children less than or equal to 5 kg, metabolic manipulation was a significantly more frequent indication for continuous venovenous hemofiltration, heparin use was lower and maximal blood flow rate was higher. We have shown that continuous venovenous hemofiltration can be performed with good outcomes in children less than or equal to 10 kg using relatively high blood flow rates and with the current equipment available.