TY  - JOUR
EP  - 941
AV  - public
Y1  - 2019/05//
TI  - Pediatric Intradialytic Hypotension: Recommendations From the Pediatric Continuous Renal Replacement Therapy (PCRRT) Workgroup
PB  - Springer Verlag
ID  - discovery10062506
N2  - 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.
KW  - Intradialytic hypotension
KW  -  children
KW  -  blood pressure monitoring
KW  -  sodium profiling
KW  -  blood
volume monitoring
KW  -  dialysate cooling
KW  -  mannitol
KW  -  midodrine
VL  - 34
SP  - 925
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
IS  - 5
SN  - 0931-041X
UR  - https://doi.org/10.1007/s00467-018-4190-1
A1  - Raina, R
A1  - Lam, S
A1  - Raheja, H
A1  - Krishnappa, V
A1  - Hothi, D
A1  - Davenport, A
A1  - Chand, D
A1  - Kapur, G
A1  - Schaefer, F
A1  - Kumar Sethi, S
A1  - McCulloch, M
A1  - Bagga, A
A1  - Bunchman, T
A1  - Warady, B
JF  - Pediatric Nephrology
ER  -