Raina, R;
Lam, S;
Raheja, H;
Krishnappa, V;
Hothi, D;
Davenport, A;
Chand, D;
... Warady, B; + view all
(2019)
Pediatric Intradialytic Hypotension: Recommendations From the Pediatric Continuous Renal Replacement Therapy (PCRRT) Workgroup.
Pediatric Nephrology
, 34
(5)
pp. 925-941.
10.1007/s00467-018-4190-1.
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Pediatric Intradialytic Hypotension: Recommendations From the Pediatric Continuous Renal Replacement Therapy (PCRRT) Workgroup |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00467-018-4190-1 |
| Publisher version: | https://doi.org/10.1007/s00467-018-4190-1 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Intradialytic hypotension, children, blood pressure monitoring, sodium profiling, blood volume monitoring, dialysate cooling, mannitol, midodrine |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10062506 |
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