Observational studyPediatric nephrology (Berlin, Germany)2019
Hemodynamic impact of the connection to continuous renal replacement therapy in critically ill children.
Observational study in Pediatric nephrology (Berlin, Germany), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Dexmedetomidine and acute kidney injury following cardiac surgery in pediatric patients-An updated systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Complications and outcomes of children under one year treated with continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026Observational
- "In-Series" Continuous Renal Replacement Therapy and Therapeutic Plasma Exchange: Single-Center Retrospective Cohort, 2018-2022.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Article
- Renal replacement therapy in intensive care unit: a narrative review.Annals of intensive care · 2026Review
- Advanced hemodynamic monitoring: feasibility of leveraging non-invasive electrocardiometry in critically ill pediatric patients requiring continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2025Observational
- A machine learning model to predict intradialytic hypotension in pediatric continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2025Article
- Article
- Impact of the first 24 h of continuous kidney replacement therapy on hemodynamics, ventilation, and analgo-sedation in critically ill children.Pediatric nephrology (Berlin, Germany) · 2024Article
- Programs and processes for advancing pediatric acute kidney support therapy in hospitalized and critically ill children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Clinical characteristics and outcomes of continuous renal replacement therapy performed on younger children weighing up to 10 kg.Turkish journal of medical sciences · 2023Observational
- The relationship between commencement of continuous renal replacement therapy and urine output, fluid balance, mean arterial pressure and vasopressor dose.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2022Article
- Hemodynamic instability during connection to continuous kidney replacement therapy in critically ill pediatric patients.Pediatric nephrology (Berlin, Germany) · 2022Article
- Characteristics of continuous venovenous hemodiafiltration in the acute treatment of inherited metabolic disorders.Pediatric nephrology (Berlin, Germany) · 2022Article
- Hemodynamic disturbances and oliguria during continuous kidney replacement therapy in critically ill children.Pediatric nephrology (Berlin, Germany) · 2021Observational
- Impact of CRRT in Patients with PARDS Treated with VV-ECMO.Membranes · 2021Article
- Continuous Renal Replacement Therapy in Critically Ill Children in the Pediatric Intensive Care Unit: A Retrospective Analysis of Real-Life Prescriptions, Complications, and Outcomes.Frontiers in pediatrics · 2021Article
- A Case Series: Continuous Kidney Replacement Therapy in Neonates With Low Body Weight.Frontiers in pediatrics · 2021Article
- Changes in hemodynamics, renal blood flow and urine output during continuous renal replacement therapies.Scientific reports · 2020Article
- Review
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundContinuous renal replacement therapy (CRRT) is the treatment of choice for critically ill children with acute kidney injury. Hypotension after starting CRRT is frequent but very few studies have analyzed its incidence and clinical relevance.
methodsA prospective, observational study was performed including critically ill children treated with CRRT between 2010 and 2014. Hemodynamic data and connection characteristics were collected before, during, and 60 min after CRRT circuit connection. Hypotension with the connection was defined as a decrease in > 20% of the mean arterial pressure from baseline or when intravenous fluid resuscitation or an increase in vasopressors was required.
resultsOne hundred sixty-one connections in 36 children (median age 18.8 months) were analyzed. Twenty-eight patients (77.8%) were in the postoperative period of cardiac surgery, 94% had mechanical ventilation, and 86.1% had vasopressors. The heparinized circuit priming solution was discarded in 8.7% and infused to the patient in 18% of the connections. The circuit was re-primed in the remaining 73.3% using albumin (79.3%), red blood cells (4.5%), or another crystalloid solution without heparin (16.2%). Hypotension occurred in 49.7% of the connections a median of 5 min after the beginning of the therapy. Fluid resuscitation was required in 38.5% and the dose of vasopressors was increased in 12.4% of the connections. There was no relationship between hypotension and age or weight. Re-priming the circuit with albumin reduced the incidence of hypotension from 71.4 to 44.6% (p = 0.004).
conclusionsHypotension after the connection to CRRT is very frequent in critically ill children. Re-priming the circuit with albumin could improve hemodynamics during connection.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.