CRRT in a Sick Child
A 30 kg child with leukemia develops septic shock with multi-organ system failure including the need for intubation, vasopressor support for hemodynamic compromise, as well as progressive oliguria with both solute and fluid retention. Current ventilator settings include a FIO2 delivery of 70%, a PEEP of 10. Blood pressure is currently 98/45 with 1 mic/kg/min of norepinephrine adjustment to keep at systolic >110 mmHg. The child is febrile with a temperature of 39 °C. Fluid overload calculations reveal that the child is 15% above dry weight with insufficient urine output to allow for adequate room for medications, nutrition, and overall medical care. Labs reveal a BUN of 69 mg/dL, a cr of 2.3 mg/dL, and a K of 5.9 meq/dL.
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