The Role of Supportive Treatment in the Management of Hyperammonemia in Neonates and Infants.
Blood Purif
; 48(2): 150-157, 2019.
Article
em En
| MEDLINE
| ID: mdl-31067532
ABSTRACT
BACKGROUND:
The objective of this study is to investigate the efficacy of continuous renal replacement therapy (CRRT), mainly continuous venovenous hemodiafiltration (CVVHDF), and evaluate vasoactive requirements in hyperammonemic neonates and infants.METHODS:
Patients who underwent CRRT for hyperammonemia were retrospectively analyzed. MEASUREMENTS AND MAINRESULTS:
Patients in 7 of the encounters were treated solely by CVVHDF. During 3 encounters, patients who received continuous venovenous hemodialysis (CVVHD) were transitioned to CVVHDF. CVVHD was used in 3 encounters. The median 50% reduction time for ammonia was 8 h (range 3-15 h). The median duration of CRRT treatment was 40 h (range 24-89 h). Survival to hospital discharge occurred in 12 encounters (92.3%). Eleven encounters (84.6%) were treated with different vasoactive agents. In those encounters, the median vasoactive medications' start time was the 6th hours (range 2-60 h) of CRRT. There was no association between the vasoactive index score and pre-dialysis ammonia concentration.CONCLUSIONS:
CRRT achieves timely control of hypeammonemic states. Hemodynamic instability necessitating intervention with vasoactive medications is a common finding in patients with hyperammonemia.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperamonemia
/
Terapia de Substituição Renal Contínua
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article