Methods of Molecular Transfusion in Intensive Care of Critical States in Pediatric Postoperative Cardiac Surgery Patients

2016 ◽  
Vol 71 (5) ◽  
pp. 341-349
Author(s):  
M. B. Yaroustovsky ◽  
M. V. Abramyan ◽  
E. V. Komardina
Keyword(s):  
Intensive Care ◽  
Pediatric Intensive Care ◽  
High Volume ◽  
Multiple Organ ◽  
Molecular Techniques ◽  
Rapid Progression ◽  
Dialysis Therapy ◽  
Timely Initiation ◽  
Extracorporeal Therapy ◽  
Reading Choice

Molecular techniques in transfusion medicine have become popular in the clinical practice of pediatric intensive care units when the patient needs blood purification, more recently, in children in critical condition. Considering the anatomical and physiological characteristics of the child’s body, pronounced severity, and rapid progression of multiple organ disorders, the key problems defining the treatment results are instrument reading, choice and timely initiation of extracorporeal therapy. Today, along with the methods of renal replacement therapy in children albumin dialysis therapy and high-volume plasmapheresis are successfully applied in the treatment of acute liver dysfunction; extracorporeal membrane oxygenation — in the treatment of biventricular cardiac and/or respiratory failure. Selective endotoxin sorption methods (LPS-adsorption) are implemented in the treatment of severe gram-negative sepsis.

scholarly journals Acute kidney injury in pediatric patients: experience of a single center during an 11-year period

Medicina ◽  
2010 ◽  
Vol 46 (8) ◽  
pp. 511 ◽  
Author(s):  
Birutė Pundzienė ◽  
Diana Dobilienė ◽  
Šarūnas Rudaitis
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Second Period

The aim of our study was to determine the causes of acute kidney injury (AKI) in children, to compare outcomes between two periods – 1998–2003 and 2004-2008 – and to evaluate the influence of new methods of renal replacement therapy on mortality. Material and methods. A retrospective analysis of medical record data of all children treated for AKI at the Clinic of Children Diseases, Hospital of Kaunas University of Medicine, during the period of 1998–2008 was made. Both periods were compared regarding various variables. Results. Of the 179 children with AKI, 75 (41.9%) were treated during 1998–2003 and 104 (58.1%) during 2004–2008. Primary glomerular disease and sepsis were the leading causes of AKI in both the periods. AKI without involvement of other organs was diagnosed for 106 (59.2%) children: for 42 (56.0%) children in the first period and 64 (61.5%) in the second. A total of 124 (69.3%) children were treated in a pediatric intensive care unit. Multiple organ dysfunction syndrome with AKI was diagnosed for 33 (44%) patients in the first period and for 40 (38.5%) in the second. A significant decrease in mortality among patients with multiple organ dysfunction syndrome during the second period was observed (78.8% vs. 37.5%). Conclusions. More than half of patients had secondary acute kidney injury of nonrenal origin. More than two-thirds (69.3%) of patients with AKI were treated in the pediatric intensive care unit. Multiple organ dysfunction syndrome was diagnosed for 40.8% of children with AKI. Renal replacement therapy was indicated for one-third of patients with AKI. A 2.5-fold decrease in mortality was observed in the second period as compared to the first one.

Sequential Blood Purification for Pediatric Fatal Toxic Epidermal Necrolysis: A Case Series

2021 ◽  
pp. 1-8
Author(s):  
Yun Cui ◽  
Jingyi Shi ◽  
Chunxia Wang ◽  
Yiping Zhou ◽  
Fei Wang ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Skin Lesions ◽  
Daily Basis ◽  
Multiple Organ ◽  
Continuous Hemofiltration ◽  
Unsuccessful Treatment ◽  
Number Of Patients ◽  
Extracorporeal Therapy

<b><i>Background:</i></b> Extracorporeal therapy that included therapeutic plasma exchange (TPE) or continuous hemofiltration (CHF) for toxic epidermal necrolysis (TEN) syndrome was used in small number of patients. We aimed to describe the sequential mode of combined application of CHF and TPE in 3 TEN patients with multiple organ dysfunction (MODS) in pediatric intensive care unit. <b><i>Methods:</i></b> Three patients with fatal TEN received sequential CHF and TPE due to unsatisfactorily conventional treatments. CHF was initiated and performed on a daily basis with 35–50 mL/kg.h replacement fluid at the rate of 3–5 mL/kg.min blood flow. CHF was temporarily interrupted for TPE, which was performed with exchange 1–1.5-fold of one body calculated plasma volume in each section. <b><i>Results:</i></b> All 3 fatal TEN (with &#x3e;30% involvement of body surface and MODS) following unsuccessful treatment with corticosteroids and intravenous immunoglobulin. Antibiotics were suspected in the TEN-triggered drugs. The range number of TPE sessions was 3–5 and the duration of CHF was from 120 h to 202 h. After initiation of TPE and CHF, blistering with extensive epidermal necrosis halted and the skin re-epithelialized within 2 weeks. Serum C-reactive protein, procalcitonin, tumor necrosis factor-α , and interlukin-6 decreased and percentage of natural killer cells increased in surviving children. Two patients survived to discharge and one case died due to nosocomial infection with multidrug-resistant <i>Acinetobacter baumannii.</i> <b><i>Conclusion:</i></b> After sequential TPE and CHF, skin lesions and inflammatory response improved in TEN. Our result indicates extracorporeal therapy could be used as an alternative modality for fatal pediatric TEN.

scholarly journals High-volume Hemofiltration in the Intensive Care Unit

2012 ◽  
Vol 116 (6) ◽  
pp. 1377-1387 ◽  
Author(s):  
Thomas Rimmelé ◽  
John A. Kellum ◽  
David S. Warner
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
High Volume ◽  
Multicenter Studies ◽  
High Volume Hemofiltration ◽  
Considerable Controversy ◽  
Extracorporeal Therapy ◽  
Renal Support

High-volume hemofiltration is an extracorporeal therapy that has been available in the intensive care unit for more than 10 yr. Recent improvements in technology have made its clinical application easier and safer. However, the definition, indications, and management of this technique are still unclear, and considerable controversy and confusion remain. The aim of this review is to analyze the available data while taking into account the distinction between two very different clinical situations: acute kidney injury requiring renal support, and severe inflammatory states where blood purification has been suggested as an adjuvant therapy. For patients with acute kidney injury requiring renal replacement therapy, the two largest multicenter studies performed to date established that high ultrafiltration flow rates are not necessary. Conversely, much experimental and some clinical evidence suggest that high-volume hemofiltration can be beneficial for the subset of critically ill patients with severe inflammatory states such as septic shock.

scholarly journals Multiple organ dysfunction in children admitted at pediatric intensive care unit of the Children Hospital, Multan.

2020 ◽  
Vol 27 (11) ◽  
pp. 2345-2349
Author(s):  
Huma Iqbal ◽  
Asim Khurshid ◽  
Ayesha Fayyaz
Keyword(s):  
Intensive Care ◽  
Organ Dysfunction ◽  
Rural Areas ◽  
Maternal Education ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Multiple Organ ◽  
Critically Ill Children ◽  
Multiple Organ Dysfunction ◽  
Residential Status

Objectives: Multiple organ dysfunction syndrome (MODS) is commonly encountered by pediatricians in Pediatric Intensive care Units (PICUs) among critically ill children. This study was done to find out the frequency of MODS in children admitted at PICU. Study Design: Case series. Setting: Department of Pediatrics Medicine, The Children’s hospital and the Institute of Child Health, Multan. Period: From May to November 2019. Material & Methods: Variables recorded for each case included age, gender, residential status, maternal education, height, weight and BMI. Venous blood sample was sent to the hospital pathology laboratory for baseline investigations to diagnose MODS. Results: Of these 101 study cases, majority, 61 (60.4 %) were male, 51 (50.5 %) belonged to rural areas, 74 (73.3%) from middle income families and 72 (71.3%) mothers of admitted children were illiterate. Overall mean age was 3.62 ± 1.95 years while mean body mass index was 24.85 ± 2.20 kg/m.2 Mean duration of PICU stay was 4.31 ± 3.39 day and 69 (68.3 %) had duration of PICU stay up to 5 days. Of these 101 study cases, multiple organ dysfunction was noted in 33 (32.7%). Conclusion: High Frequency of MOD was observed among children admitted to PICU. MODS was found to have association with male gender, residential status as rural, maternal education status as illiterate, obesity and duration of PICU of more than 5 days.

Mortality associated with multiple organ system failure and sepsis in pediatric intensive care unit

1987 ◽  
Vol 111 (3) ◽  
pp. 324-328 ◽  
Author(s):  
James D. Wilkinson ◽  
Murray M. Pollack ◽  
Nancy L. Glass ◽  
Robert K. Kanter ◽  
Robert W. Katz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Multiple Organ ◽  
Organ System ◽  
System Failure ◽  
Multiple Organ System ◽  
Organ System Failure ◽  
Multiple Organ System Failure
Sign in / Sign up

Export Citation Format

Share Document