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Discussion

Neonatal dialysis?!

Has anyone read the Medscape article on the first successful use of CRRT in a neonate?

Miniaturized Dialysis Machine Successful for First Neonate

http://www.medscape.com/viewarticle/825622 (requires a login, but free to join)

The kiddo was 5.2kg at time of treatment, which seems more like a toddler to me! Exciting news but I would be terrified to be the nurse running it.

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    I did see that. 5.2kg is HUGE for a neonate- I wondered if they used PD until the baby got that size, or if it was the first treatment choice?

    We do PD typically on newborns. Unless they're on ECMO

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    Yeah, I've heard this is coming; one of the renal docs at my hospital mentioned it in passing a few weeks ago.

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    • Author

    I was hoping the article would be a little more detailed about the process. We don't do PD in my unit. Do the babies have a weight limit to qualify?

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    We usually do PD for the chronic renal failure babies who will need dialysis until they get a kidney transplant. For the babies that are super sick and need dialysis d/t acute reasons if they are really sick enough they will try CRRT or HD in the PICU. Not very often though and they have to be really sick and a good size (probably at least 8lbs!)

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    We do PD dialysis and have sent out a couple of kids for hemodialysis.

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    • Author

    I didn't realize PD and HD happen this frequently in other units. We had one kiddo awhile back who could have definitely used it. CRRT seems much more realistic now.

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    Excited for the advancement. But 5.2kg is huge!

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    We use regular crrt (as in the same machine the picu uses) in our cardiac icu neonates all the time with or without ecmo. Smallest i've seen was 3kg. I'll have to read that article at some point

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    • Expert

    ^Yeah we do too... we had our very first neonatal CVVHDF/CRRT via ECMO circuit patient recently. Very interesting case, as we had to learn very quickly how to manage one more machine at the bedside :p

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