%0 Journal Article
%@ 0931-041X
%A Raina, R
%A Lam, S
%A Raheja, H
%A Krishnappa, V
%A Hothi, D
%A Davenport, A
%A Chand, D
%A Kapur, G
%A Schaefer, F
%A Kumar Sethi, S
%A McCulloch, M
%A Bagga, A
%A Bunchman, T
%A Warady, B
%D 2019
%F discovery:10062506
%I Springer Verlag
%J Pediatric Nephrology
%K Intradialytic hypotension, children, blood pressure monitoring, sodium profiling, blood  volume monitoring, dialysate cooling, mannitol, midodrine
%N 5
%P 925-941
%T Pediatric Intradialytic Hypotension: Recommendations From the Pediatric Continuous Renal Replacement Therapy (PCRRT) Workgroup
%U https://discovery.ucl.ac.uk/id/eprint/10062506/
%V 34
%X Intradialytic hypotension (IDH) is a common adverse event resulting in premature  interruption of hemodialysis, and consequently, inadequate fluid and solute removal. IDH  occurs in response to the reduction in blood volume during ultrafiltration and subsequent  poor compensatory mechanisms due to abnormal cardiac function or autonomic or  baroreceptor failure. Pediatric patients are inherently at risk for IDH due to the added  difficulty of determining and attaining an accurate dry weight. While frequent blood pressure  monitoring, dialysate sodium profiling, ultrafiltration guided blood volume monitoring,  dialysate cooling, hemodiafiltration, and intradialytic mannitol and midodrine have been  used to prevent IDH, they have not been extensively studied in pediatric population. Lack of  large-scale studies on IDH in children makes it difficult to develop evidence based  management guidelines. Here we aim to review IDH preventative strategies in the pediatric  population and outlay recommendations from the Pediatric Continuous Renal Replacement  Therapy (PCRRT) Workgroup. Without strong evidence in the literature, our  recommendations from the expert panel reflect expert opinion and serves as a valuable  guide.
%Z This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.