Novel use of an ultrafiltration device as an alternative method for fluid removal in critically ill pediatric patients with cardiac disease: a case series

  • Sujata Chakravarti | sujata.chakravarti@nyumc.org Division of Pediatric Cardiology, Department of Pediatrics, New York University School of Medicine, NY, United States.
  • Yasir Al-Qaqaa Division of Pediatric Critical Care, Department of Pediatrics, New York University School of Medicine, NY, United States.
  • Meghan Faulkner Division of Pediatric Cardiology, Department of Pediatrics, New York University School of Medicine, NY, United States.
  • Puneet Bhatla Division of Pediatric Cardiology, Department of Pediatrics, New York University School of Medicine, NY, United States.
  • Michael Argilla Division of Pediatric Cardiology, Department of Pediatrics, New York University School of Medicine, NY, United States.
  • Michelle Ramirez Division of Pediatric Critical Care, Department of Pediatrics, New York University School of Medicine, NY, United States.

Abstract

Fluid overload (FO) is a common complication for pediatric patients in the intensive care unit. When conventional therapy fails, hemodialysis or peritoneal dialysis is classically used for fluid removal. Unfortunately, these therapies are often associated with cardiovascular or respiratory instability. Ultrafiltration, using devices such as the AquadexTM system (Baxter Healthcare, Deerfield, IL, USA), is an effective tool for fluid removal in adult patients with congestive heart failure. As compared to hemodialysis, ultrafiltration can be performed using smaller catheters, and the extracorporeal volume and minimal blood flow rates are lower. In addition, there is no associated abdominal distension as is seen in peritoneal dialysis. Consequently, ultrafiltration may be better tolerated in critically ill pediatric patients. We present three cases of challenging pediatric patients with FO in the setting of congenital heart disease in whom ultrafiltration using the AquadexTM system was successfully utilized for fluid removal while cardiorespiratory stability was maintained.

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Published
2016-06-23
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Section
Case Reports & Letters
Keywords:
Fluid overload, acute kidney injury, congenital heart disease, ultrafiltration
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How to Cite
Chakravarti, S., Al-Qaqaa, Y., Faulkner, M., Bhatla, P., Argilla, M., & Ramirez, M. (2016). Novel use of an ultrafiltration device as an alternative method for fluid removal in critically ill pediatric patients with cardiac disease: a case series. Pediatric Reports, 8(2). https://doi.org/10.4081/pr.2016.6596