Document Detail


High-volume continuous venovenous hemofiltration as an effective therapy for acute management of inborn errors of metabolism in young children.
MedLine Citation:
PMID:  17643056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIM: Renal replacement therapies (RRTs) have been used for the acute management of inborn errors of metabolism. Hemodialysis is the most effective modality. The aim of this article is to demonstrate that high-volume hemofiltration can offer an alternative way to effectively remove small molecules. METHODS: Eight patients presented with acute neurological deterioration due to ammonia or organic acid accumulation. Different RRTs were applied, including continuous venovenous hemofiltration (CVVH, n = 7), continuous arteriovenous hemofiltration (CAVH, n = 2), continuous venovenous hemodialysis (CVVHD, n = 1), intermittent hemodialysis (HD, n = 1), and peritoneal dialysis (PD, n = 2). RESULTS: Ammonia 50% reduction time in HD was 1.7 h while in CVVH it was 2-14.5 h. The greater the ultrafiltration flow was, the sooner patients regained consciousness. CAVH, CVVHD or PD was not sufficient enough. CONCLUSION:CVVH also has a good clearance for organic acid and ammonia if applying high-volume hemofiltration (>35 ml/kg/h). It can be therefore be considered as an alternative therapy if infant HD is not available.
Authors:
Yi-Chun Lai; Hsin-Ping Huang; I-Jung Tsai; Yong-Kwei Tsau
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2007-07-20
Journal Detail:
Title:  Blood purification     Volume:  25     ISSN:  1421-9735     ISO Abbreviation:  Blood Purif.     Publication Date:  2007  
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  303-8     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Affiliation:
Division of Pediatric Nephrology, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Carbamoyl-Phosphate Synthase I Deficiency Disease / therapy
Child
Child, Preschool
Female
Hemofiltration / methods*
Humans
Hyperammonemia / etiology,  therapy*
Infant
Infant, Newborn
Infection / blood,  complications
Male
Maple Syrup Urine Disease / therapy
Metabolism, Inborn Errors / blood,  complications,  therapy*
Methylmalonic Acid / blood
Ornithine Carbamoyltransferase Deficiency Disease / therapy
Renal Replacement Therapy / methods
Treatment Outcome
Chemical
Reg. No./Substance:
516-05-2/Methylmalonic Acid

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