Continuous venovenous haemofiltration in neonates with renal insufficiency resulting from low cardiac output syndrome after cardiac surgery.

Acute renal insufficiency is a common complication after surgery for congenital cardiovascular defects in neonates and is associated with a high incidence of morbidity and mortality. The authors reviewed their experience with continuous venovenous haemofiltration in neonates and infants with acute renal insufficiency resulting from low cardiac output following cardiovascular surgery. Twelve critically ill patients with pharmacologically intractable fluid overload were treated with continuous venovenous haemofiltration over a period of 42 months. All patients were mechanically ventilated and dependent on high doses of catecholamines. Continuous venovenous haemofiltration was started 64.2(28.2) h postoperatively and maintained for a period of 8 to 195 h. A negative fluid balance was achieved in all patients (2.1(0.5) ml/kg per h). No complications relating to continuous venovenous haemofiltration were evident during the treatment. The survival rate was 59% (seven of 12). Continuous venovenous haemofiltration is a valid and simple method for controlling fluid overload in neonates and infants with low cardiac output.