Continuous Renal Replacement Therapy (CRRT) in Children and the Specialized CRRT Team: A 14-Year Single-Center Study

Abstract

Continuous renal replacement therapy (CRRT) has been used as an important intervention in critically ill children. Our center has the only specialized CRRT team (SCT) for children in Korea, which consists of pediatric intensivists, a pediatric nephrologist and CRRT-specialized-nurses. This study was a retrospective single-center analysis, including all pediatric patients admitted to the intensive care unit (ICU) of Severance hospital in Korea and received CRRT between 2003 and 2016, grouped as before SCT (group A, n = 51) and after SCT (group B, n = 212). We obtained the data for sex, age, weight, diagnosis, blood flow rate or type of CRRT machine used, administration of inotropic agents or anticoagulants, and ICU duration before CRRT (hours). A total of 263 patients were included. The age was significantly younger (p < 0.001) and blood flow rate was lower (p = 0.001) in group B than group A. Vasopressors (p < 0.001), continuous veno-venous hemodiafiltration (CVVHDF) (p < 0.001), nafamostat mesilate (p < 0.001), and extracorporeal membrane oxygenation (ECMO)-CRRT (p = 0.004) were more frequently used in group B. Based on our 14-year experience, we conclude that SCT operation could have played an important role in increasing the amount of CRRT utilization.

Novel genetic variants associated with brain functional networks in 18,445 adults from the UK Biobank

“…A previous study has also linked reductions in intrinsic functional connectivity in the somatomotor network to participants with subclinical hypothyroidism compared to controls 27 . Interestingly, studies have also found subclinical thyroid dysfunction to be associated with sleep quality 28 , 29 . Other genes located in this intergenic region near PAX8 include CBWD2 and CHCHD5, which have also been associated with sleep duration in prior studies 30 , 31 .…”

Continuous Renal Replacement Therapy in Critically Ill Children in the Pediatric Intensive Care Unit: A Retrospective Analysis of Real-Life Prescriptions, Complications, and Outcomes

“…In a large multicenter observational study, only 1.5% of critically ill children underwent CRRT (2). A knowledge gap exists regarding clinical and technical peculiarities of CRRT in the pediatric population (7), and several researchers in the field encourage the sharing of experiences and clinical and technical data (8)(9)(10)(11). Predictors for circuit clotting are mostly unknown and originate from large cohorts of adult patients (12,13).…”

Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

“… 24 Single center, Turkey CRRT 2010–2015 50 42% at discharge Lee et al . 25 Single center, Korea CRRT 2003–2016 263 30% at discharge Tain et al . 26 Taiwan’s health care delivery system HD, PD, CRRT 2010–2017 412 6.59% of 23,759 encounters in 412 pediatric patients 66.4% at discharge Yetimakman et al .…”