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Overview CRRT in children at two centers in Czech republic for 5years (2000 – 2005)

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. Czech republic. 10MILLION INH. CHILDREN 2.5MILLION.

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Overview CRRT in children at two centers in Czech republic for 5years (2000 – 2005)

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  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 ZURICH 4TH PCRRT FEBRUARY 2006

  2. Czech republic • 10MILLION INH. • CHILDREN 2.5MILLION ZURICH 4TH PCRRT FEBRUARY 2006

  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 ZURICH 4TH PCRRT FEBRUARY 2006

  4. Center Census N = 40 N = 70 CENTER ZURICH 4TH PCRRT FEBRUARY 2006

  5. DEMOGRAPHICS • Age 8,8 ± 7,6years • Weight 29,2 ± 25,4 kg • Gender F 27% M 63% • Total 110 children ZURICH 4TH PCRRT FEBRUARY 2006

  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 67,6%  35ml/kg/hour 40 – 60kg 36%  35ml/kg/hour  60kg 23%  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 ZURICH 4TH PCRRT FEBRUARY 2006

  7. Modality MODALITY ZURICH 4TH PCRRT FEBRUARY 2006

  8. Vascular acces ZURICH 4TH PCRRT FEBRUARY 2006

  9. Anticoagulation Anticoagulation CRRT 20% 3% 21% Heparin LMWH Citrate WITHOUT 56% ZURICH 4TH PCRRT FEBRUARY 2006

  10. Anticoagulation: median life filter • Heparin 43hrs (range 20–49hrs) • LMWH 38hrs (17-46hrs) • Citrate 62hrs (32 –70hrs) one center only ZURICH 4TH PCRRT FEBRUARY 2006

  11. Number of units transfused per day of CRRT ZURICH 4TH PCRRT FEBRUARY 2006

  12. Circuit change reason ZURICH 4TH PCRRT FEBRUARY 2006

  13. PRIMARY DISEASE ZURICH 4TH PCRRT FEBRUARY 2006

  14. REASON TO START ZURICH 4TH PCRRT FEBRUARY 2006

  15. Mortality in children with sepsis +/­ ARF ZURICH 4TH PCRRT FEBRUARY 2006

  16. COMPLETE OUTCOME ZURICH 4TH PCRRT FEBRUARY 2006

  17. SUBGROUPS MORTALITY ZURICH 4TH PCRRT FEBRUARY 2006

  18. THANK YOU FOR YOUR ATTENTION Oddělení dětské intenzivní a resuscitační péče FAKULTNÍ NEMOCNICE S POLIKLINIKOU OSTRAVA-PORUBA 17.listopadu 1790 Czech republic Email: tomas.zaoral@fnspo.cz Finally our beginnings ZURICH 4TH PCRRT FEBRUARY 2006

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