A PRACTICAL APPROACH TO CONTINUOUS HEMOFILTRATION IN INFANTS AND CHILDREN

Continuous hemofiltration (CH) is commonly used to treat critically il l children with acute renal failure. In spite of its widespread use, p ractical guidelines for performing CH in children are not easily avail able. This article reviews the use of CH in children, focusing an issu es unique to pediatric patients, including vascular access, circuit se lection and volumes (hemofilters and tubing sets), blood pump use for venovenous CH, replacement fluid and dialysate selection, ultrafiltrat ion and dialysate flow rates, glycemic control, body temperature regul ation, and the use of anticoagulation. The recommendations given shoul d be considered as starting points for CH; refinements should be based on patient need, experience of the practitioners, and available resou rces.