Continuous arteriovenous haemofiltration in the newlyborn with acute renal failure and congenital heart disease

Newlyborn infants with congenital heart disease who develop acute renal failure are particularly difficult to treat. There are often complex associated medical problems and the mortality is high. Continuous arteriovenous haemofiltration (CAVH) provides a slow and gentle removal of fluid, together wi...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 1989, Vol.4 (10), p.870-876
Main Authors: HENEY, D, BROCKLEBANK, J. T, WILSON, N
Format: Article
Language:English
Subjects:
Acute Kidney Injury - blood
Acute Kidney Injury - therapy
Biological and medical sciences
Heart Defects, Congenital - blood
Hemofiltration - methods
Humans
Infant, Newborn
Infusion Pumps
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Renal Dialysis
Renal failure
Urea - blood
Water-Electrolyte Balance
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Summary:Newlyborn infants with congenital heart disease who develop acute renal failure are particularly difficult to treat. There are often complex associated medical problems and the mortality is high. Continuous arteriovenous haemofiltration (CAVH) provides a slow and gentle removal of fluid, together with the possibility of correcting metabolic abnormalities. We used CAVH in six newlyborn infants all with severe congenital heart disease, who developed acute renal failure early in life. In four patients it was necessary to insert a blood pump into the circuit to maintain adequate blood flow. CAVH alone, with or without a blood pump, was unable to reduce the plasma urea and creatinine, and in three of the infants, dialysis across the filter was required. CAVH was effective in controlling fluid balance. Although mortality remains high we feel CAVH has an important role in selected patients.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/4.10.870