Continuous arteriovenous hemofiltration in children.

Continuous arteriovenous hemofiltration (CAVH) is an extracorporeal technique for the treatment of hypervolemia and electrolyte disturbances in the critically ill patient with oligoanuria. The patient's cardiac output provides the blood flow through the circuit; no pumps are necessary. A range of hemofilters is now available extending the applicability of CAVH to the pediatric population, including premature newborns. In this report the treatment of 15 neonates and 8 older children is described. Fluid overload was reduced in all cases. Reflecting the very grave clinical conditions of these patients, 15 of the 23 treated children ultimately died. Due to failure to control uremia, four patients required treatment with dialysis. CAVH was found to be generally safe and effective even in the hemodynamically unstable critically ill child.