Predictors of Mortality and Complication in Pediatric Patients Who Require Continuous Renal Replacement Therapy in Pediatric Intensive Care Unit.
10.4266/kjccm.2011.26.3.171
- Author:
Jae Wook CHOI
1
;
Woo Jin CHUNG
;
Young Joo HAN
;
Ju Kyung LEE
;
Dong In SUH
;
June Dong PARK
;
Young Yull KOH
Author Information
1. Department of Pediatric Medicine, Seoul National University College of Medicine, Seoul, Korea. jdparkmd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
acute renal failure;
continuous renal replacement therapy;
fluid overload;
PRISM III;
uric acid
- MeSH:
Acute Kidney Injury;
Catheterization;
Catheters;
Child;
Hemorrhage;
Humans;
Hypotension;
Critical Care;
Intensive Care Units;
Multivariate Analysis;
Renal Replacement Therapy;
Retrospective Studies;
Risk Factors;
Stem Cell Transplantation;
Uric Acid;
Weights and Measures
- From:The Korean Journal of Critical Care Medicine
2011;26(3):171-176
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The objective of this study is to analyze the factors associated with mortality and complication in children requiring continuous renal replacement therapy (CRRT) in a pediatric intensive care unit. METHODS: We retrospectively analyzed 96 patients who required CRRT at a pediatric intensive care unit in Seoul National University Hospital between April 2005 and April 2011. We evaluated the clinical features, diagnosis, mortality risk factors and complications related to CRRT. RESULTS: Univariate and multivariate analyses were performed to analyze the mortality risk factors of patients requiring CRRT. The overall mortality was 56.3%, the median age was 8 years, and the ages ranged from 4 days to 22 years. The median weight of the patients was 7.9 kg, and the weights ranged from 3.6-72.9 kg. 16 patients were diagnosed with primary renal disease, and the remainder with other underlying diseases. Mortality was higher in children who received stem cell transplantation and in children with a diagnosis of imunologic disease and neurologic disease. The Pediatric Risk of Mortality (PRISM) III score at initiating CRRT was 17.8 +/- 8.9 and the degree of fluid overload at CRRT (FO%) was 12.9 +/- 16.0. The PRISM III score at the start of CRRT and low uric acid level were the factors associated with an increased risk of mortality. Of the 96 children, 13 (13.53%) presented problems of venous catheterization. Hypotension during connection to CRRT was detected in 28 patients (29.2%). Clinically significant hemorrhage occurred in 10 patients (10.4%). CONCLUSIONS: Children who require CRRT have a high mortality rate. The higher score of PRISM III at the starting time of CRRT and the lower uric acid level are the factors associated with a higher mortality. The most frequent complication of CRRT was hypotension on connection to CRRT.
