1. Overview CRRT in children at two centers in Czech republic for 5years (2000 – 2005)
T.Zaoral,M.Hladík,
M.Sádlo, V.Vobruba
PICU, Ped.nephrology, Children´s Hospital Ostrava
PICU, Children´s Hospital Prague
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2. Czech republic 10MILLION INH. CHILDREN 2.5MILLION ZURICH 4TH PCRRT
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3. Retrospective data for 5years at 2centers in Czech republic
Each center follows own institutional practice
- INITIATION AND TERMINATION
- ANTICOAGULATION PROTOCOLS
- MODALITY OF CRRT
- FLUIDS
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4. Center Census
N = 40
N = 70
CENTER
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5. DEMOGRAPHICS Age 8,8 ± 7,6years Weight 29,2 ± 25,4 kg
Gender F 27% M 63%
Total children
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6. Results 142 patients collected 110 with complete data 344 circuits
single circuit mean time 38 ± 21,9hrs (range 6 – 98hrs)
Mean lenght of CRRT = 75hrs, median = 88hrs (range 6 – 216hrs =9D)
Amount of dose (ml/kg/hr) :
 40kg ,6%  35ml/kg/hour
40 – 60kg 36%  35ml/kg/hour
 60kg %  35ml/kg/hour
C.Ronco,R.Bellomo,P.Homel, A.Brendolan et al.: Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomise trial : Lancet 2000, Vol.356  26-30
Frequency of changing set :
Ostrava: q. 36hrs
Prague : q. 48hrs
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7. Modality
MODALITY
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8. Vascular acces
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9. Anticoagulation Anticoagulation CRRT 20% 3% 21% Heparin LMWH Citrate
WITHOUT
56%
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10. Anticoagulation: median life filter
Heparin 43hrs (range 20–49hrs)
LMWH 38hrs (17-46hrs)
Citrate hrs (32 –70hrs) one center only
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11. Number of units transfused per day of CRRT
Heparin
n = 61
Citrate
n = 22 p
Patients trf %
29 (48%)
8 (27%)
< 0,05
Number of
unit trf per day CRRT
1.0 (0 – 2.0)
0.3 ( 0 – 0.7)
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12. Circuit change reason
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13. PRIMARY DISEASE
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14. REASON TO START
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15. Mortality in children with sepsis +/­ ARF
PRISM 2
ADMISSION
INITIATION CRRT
MORTALITY
SEPSIS WITHOUT ARF
17,8 ± 1,2
21,6 ± 2,6
40%
SEPSIS WITH ARF
21,4 ± 1,6
23,6 ± 1,8
62%
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16. COMPLETE OUTCOME
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17. SUBGROUPS MORTALITY
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18. THANK YOU FOR YOUR ATTENTION
Oddělení dětské intenzivní a resuscitační péče
FAKULTNÍ NEMOCNICE S POLIKLINIKOU OSTRAVA-PORUBA
17.listopadu 1790
Czech republic
Finally our beginnings
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FEBRUARY 2006