Examination of the continuous blood purification therapy in children in the intensive care unit of our hospital

Abstract

We did not have a system of rapid response to problems in continuous blood purification therapy (CBP) in children when we started to perform this therapy in the intensive care unit (ICU) of our hospital. Therefore, we retrospectively analyzed the results of CBP in children in the ICU of our hospital. We performed CBP for a total of 104 days in seven children over a three-year period. For patients whose body weight was less than 20kg, red cell concentrates and fresh frozen plasma were used as the priming solution. Diafiltration was performed before the start of extracorporeal circulation to correct electrolytes and to warm the circuit. Exchange of the circuit was performed every 24hours by connecting the current circuit to the new circuit in series. Seventy-four adverse events occurred in total. The most frequent adverse event was intra-circuit coagulation (34events). However, we have learned many troubleshooting techniques with the accumulation of experience. We can now smoothly cope with such problems because we created a manual and we have workshops where we discuss any problems that occurred. The anxiety of our clinical engineers has decreased. Stable blood purification therapy cannot be achieved with intra-circuit coagulation. Therefore, it is necessary to deal with intra-circuit coagulation immediately.