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Erschienen in: Intensive Care Medicine 5/2010

01.05.2010 | Pediatric Original

Clinical course and mortality risk factors in critically ill children requiring continuous renal replacement therapy

verfasst von: Maria J. Santiago, Jesús López-Herce, Javier Urbano, Maria José Solana, Jimena del Castillo, Yolanda Ballestero, Marta Botrán, Jose María Bellón

Erschienen in: Intensive Care Medicine | Ausgabe 5/2010

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Abstract

Objective

To study the clinical course in children requiring continuous renal replacement therapy (CRRT) and to analyse factors associated with mortality.

Design

Prospective observational study.

Setting

Paediatric intensive care department of a tertiary university hospital.

Patients

Critically ill children with CRRT were included in the study.

Intervention

Continuous renal replacement therapy.

Measurements and results

Univariate and multivariate analyses were performed to analyse the influence of each factor on mortality. The ability of the PRISM, PIM II and PELOD severity of illness scores to predict mortality was tested using receiver-operating characteristic curve statistics. A total of 174 children aged between 1 month and 22 years were treated with CRRT. Mortality was 35.6%, and multiorgan failure and haemodynamic disturbances were the principal causes of death. Mortality was higher in children less than 12 months of age (44.7%; P = 0.037) and in patients with a diagnosis of sepsis (44.1%; P = 0.001). Haemodynamic disturbances at the time of starting CRRT (hypotension or need for adrenaline >0.6 µg/kg/min) and the presence of multiorgan failure were the factors associated with an increased risk of mortality. The PRISM scale was the severity score with the best predictive capacity, although all three scales underestimated the actual mortality.

Conclusions

Mortality in children who require CRRT is high. Haemodynamic disturbances and the presence of multiorgan failure at the time of starting the technique are the factors associated with a higher mortality. The clinical severity scores underestimate mortality in children requiring CRRT.
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Metadaten
Titel
Clinical course and mortality risk factors in critically ill children requiring continuous renal replacement therapy
verfasst von
Maria J. Santiago
Jesús López-Herce
Javier Urbano
Maria José Solana
Jimena del Castillo
Yolanda Ballestero
Marta Botrán
Jose María Bellón
Publikationsdatum
01.05.2010
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 5/2010
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1858-9

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