Valerijus Karmanovas
Abstract
Objective: To rewiev our experience in renal replacement therapy and blood purification during 19885-2011 years in children with organ failure Methods: charchoal hemoperfusion, plasmapheresis, plasmafiltration, continuous veno- venous hemofiltration- hemodiafiltration, peritoneal hemodialysis, coupled plasmafiltration-adsorbtion. Results: On the whole during that period were performed 1524 procedures: hemocarboperfusion (HSP), plasmafiltration or plasmaferesis (PF), continous veno-venous hemofiltration or hemodiafiltration (CVVH, CVVHDF), peritoneal dialysis (PD), coupled plasmafiltration-adsorbtion (CPFA) or their combination due to clinical evidence. Mortality rate in patients with multiple organ distress syndrome was 47,8%, acute hepatic failure-36,8%,with renal failure-2,2%, patients with prerenal cause- 38% (most patients with sepsis and multiple organ failure). Prospective, randomized controlled trials are one of the most valid guides to practice, but there were contradictory or inconclusive results. Hense, due to our clinical evidence we are trying to embark further research into treatment, suggesting practical algorithms. Conclusion:renal replacement therapy and blood purification becomes one of the most important parts in multiple organ failure treatment in children.The most important thing:indications, time , equipment, experience, validity.
Keyword(s): renal replacement therapy; blood purification; multiple organe failure; sepsis;acute hepatic failure
DOI: 10.5200/394
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