Hemodialysis in the Premature Infant

Bock, Glenn H.; Campos, Alfonso; Thompson, Theodore R.; Maher, Sherif; Kjellstrand, Carl M.

doi:10.1001/archpedi.1981.02130260066020

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…'0 34 35 All very small ultrafilters and dialysers are of hollow fibre design with parallel capillary membranes packed into a plastic cylinder. Several have good ultrafiltration and dialysis characteristics and can be used for either purpose: I will refer to them all as filters.…”

Section: Dialysis or Filtration?mentioning

confidence: 99%

“…'524 An umbilical arterial catheter may sometimes provide an easy route for access. 0 24 27 3435 Femoral arterial puncture can be prohibitive in a mature baby45; inserting an arterial line into an oedematous VLBW baby is daunting and seldom produces sufficient flow. We have seen older children require femoral artery repair after prolonged CAVHD; VLBW infants are likely to fare worse.…”

mentioning

confidence: 99%

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Managing acute renal failure in very low birthweight infants.

Coulthard¹,

Vernon²

1995

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Section: Dialysis or Filtration?mentioning

confidence: 99%

mentioning

confidence: 99%

Managing acute renal failure in very low birthweight infants.

Coulthard¹,

Vernon²

1995

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…Resultant poor flows may prevent effective dialysis, and lead to clotting within the dialyser. Though haemodialysis has been reported in infants of around 2 kg, it is certainly technically difficult [5], and has been considered impossible in smaller preterm infants [6].…”

Section: Introductionmentioning

confidence: 99%

A machine for haemodialysing very small infants

et al. 2005

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Babies weighing under 6 kg are difficult to dialyse, especially those as small as 1 kg. Peritoneal dialysis is easier than haemodialysis, but is not always possible, and clears molecules less efficiently. Two factors complicate haemodialysis. First, extracorporeal circuits are large relative to a baby's blood volume, necessitating priming with fresh or modified blood. Second, blood flow from infants' access vessels is disproportionately low (Poiseuille's law), causing inadequate dialysis, or clotting within the circuit. These problems are minimised by using single lumen access, a very small circuit, and a reservoir syringe to separate the sampling and dialyser blood flow rates. Its manual operation is tedious, so we developed a computer-controlled, pressure-monitored machine to run it, including adjusting the blood withdrawal rate from poorly sampling lines. We have dialysed four babies weighing 0.8-3.4 kg, with renal failure or metabolic disorders. The circuits did not require priming. Clearances of creatinine, urea, potassium, phosphate and ammonia were mean (SD) 0.54 (0.22) ml/min using one dialyser, and 0.98 (0.22) ml/min using two in parallel. Ammonia clearance in a 2.4 kg baby had a 9 h half-life. Ultrafiltration up to 45 ml/h was achieved easily. This device provided infants with immediate, effective and convenient haemodialysis, typically delivered for prolonged periods.

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Hemodialysis in the Premature Infant

Cited by 2 publications

References 6 publications

Managing acute renal failure in very low birthweight infants.

Managing acute renal failure in very low birthweight infants.

A machine for haemodialysing very small infants

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