Comparison between sustained low-efficiencydialysis (SLED) and continuous renal replacement therapy (CRRT) in patients of septic shock: a randomized controlled trial

Mishra, SB; Azim, Afzal; Baronia, AK; Singh, R. K.; Gurjar, Mohan; Poddar, Banani

doi:10.1186/2197-425x-3-s1-a55

Cited by 1 publication

(2 citation statements)

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“…[1][2][3] The low efficiency of SLED is achieved by setting low blood (Qb) and dialysate flow rates (Qd) with a Qd:Qb of 2:1, 1:1, or even less. Sustained low-efficiency dialysis (SLED) using existing HD machines and familiar technology is emerging as a cost-effective alternative for adults and older children in many parts of the world.…”

Section: Introductionmentioning

confidence: 99%

“…Sustained low-efficiency dialysis (SLED) using existing HD machines and familiar technology is emerging as a cost-effective alternative for adults and older children in many parts of the world. [1][2][3] The low efficiency of SLED is achieved by setting low blood (Qb) and dialysate flow rates (Qd) with a Qd:Qb of 2:1, 1:1, or even less. In order to provide SLED for children weighing less than 10 kg who would have a Qb of 50 to 60 mL/minute, the HD machine should be able to deliver dialysate flows of 100 mL/minute.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of prolonged daily hemodialysis in critically ill children weighing less than 10 kg

Ali

Arya

2019

Hemodialysis International

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Introduction: Extracorporeal renal replacement therapy may be needed in those infants in whom peritoneal dialysis is not feasible or is ineffective. Prolonged daily hemodialysis (PDHD) remains the only available extracorporeal dialytic modality in children weighing less than 10 kg, in setups where continuous renal replacement therapy is unavailable and sustained low-efficiency dialysis is not feasible due to lack of dedicated HD machines capable of delivering very low dialysate flows. The use of PDHD in critically ill children weighing less than 10 kg has not received much attention.Methods: Retrospective analysis of the efficacy and safety of PDHD in critically ill children weighing less than 10 kg.Findings: Four critically ill children received a total of 49 sessions of PDHD for acute kidney injury (AKI) associated with sepsis and multiorgan dysfunction syndrome (MODS). PDHD was delivered for a duration of 6 to 8 hours daily with low ultrafiltration rates, low blood flow rates but with dialysate rates that were four times the blood flow rates, due to limitations of minimal dialysate flow rate on standard machines. The mean duration of the sessions was 6.59 AE 1.61 hours. Mean hourly ultrafiltrate (UF) rate during the sessions was 9.28 AE 2.57/kg/hour with mean patient fluid removal rate of 5.4 AE 2.56 mL/kg/hour. Predialysis serum creatinine decreased to 30% of the starting value by the fourth hemodialysis (HD) session. Thirty-three (67.4%) sessions were heparin free. Intradialytic hypotension occurred in 10 (20.4%) sessions. Premature termination of the session occurred in six (12.4%), due to hypotension in two and filter clotting in four. Hypokalemia was seen in 12 (24.4%) and hypophosphatemia in 6 (12.24%). All four patients survived. On follow-up, three are dialysis free and one is on maintenance hemodialysis.Conclusion: PDHD is effective and safe in critically ill small children.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%