Continuous renal replacement therapy in clinical management of neonatal sepsis-related acute kidney injury
10.3760/cma.j.issn.2096-2932.2019.06.009
- VernacularTitle:连续性肾脏替代治疗救治新生儿脓毒症相关性急性肾损伤临床分析
- Author:
Yihuan CHEN
1
;
Cheng CAI
;
Gang QIU
;
Xiaohui GONG
;
Wenchao HONG
;
Yunlin SHEN
Author Information
1. 上海市儿童医院
- Keywords:
Sepsis;
Acute kidney injury;
Continuous renal replacement therapy;
Infant;
newborn
- From:Chinese Journal of Neonatology
2019;34(6):443-447
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study efficacy and safety of continuous renal replacement therapy (CRRT) in the treatment of neonatal sepsis-related acute kidney injury (AKI).Method From June 2011 to June 2018,neonates with sepsis-related AKI hospitalized in the neonatal intensive care unit of our hospital and treated with CRRT were enrolled.Before CRRT,12 h,24 h,48 h after CRRT and by the end of CRRT,their clinical data including renal function,acid-base balance,electrolytes,blood pressure (BP)and the change of hemodynamic indexes were retrospectively analysed.The efficacy and safety of CRRT was evaluated.Kruskal-wallis H test was used for statistical analysis.Result A total of 9 cases of sepsis-related AKI neonates were enrolled in the study,all treated with continuous veno-venous hemofiltration dialysis.5 cases had oliguria,2 cases fluid overload and 2 cases shock.The duration of CRRT was 49 ～ 110 h (76.2 ±23.5) h.12 h after CRRT,BP were maintained at 40 ～60 mmHg and stable during the treatment,the blood pH value increased to 7.35 ～ 7.45 and the oxygenation index reached 200 mmHg.24 h after CRRT,the oxygenation index rose to more than 300 mmHg.Serum potassium,urea nitrogen and creatinine levels decreased significantly after 12 h of CRRT,and reached the normal range after 24 h of CRRT.After 24 h of CRRT,the urine volume significantly increased.Venous catheterization was performed successfully in 9 cases.2 cases had thrombocytopenia,1 case catheterization obstruction and 1 case hypotension during CRRT.No complications such as hypothermia,hemorrhage,thrombosis or infection occurred.All 9 patients were cured and discharged.Conclusion CRRT is safe and effective for the treatment of neonatal sepsis-related AKI.
