Vascular Access in a Child with Acute Kidney Injury
- 534 Downloads
A 7-year-old male was admitted to the pediatric intensive care unit (PICU) after suffering internal injuries after a motor vehicle accident. Specifically, he sustained a liver laceration, from which he hemorrhaged, requiring multiple blood transfusions. His urine output has progressively decreased over the past 4 days, and now, on hospital day 5, his urine output has been less than 5 mL/h. He remains intubated and sedated, requiring ventilator support. You have been involved with his care since hospital day 2, and you have obtained a renal ultrasound which showed normal-sized kidneys with increased echogenicity and poor corticomedullary differentiation, consistent with medical renal disease. His serum creatinine on admission was 0.7 mg/dL and has progressively increased to 4.8 mg/dL at the present time. His serum chemistries at the present time are presented below.
- 4.Hackbarth R, Bunchman TE, Chua AN, Somers MJ, Baum MA, Symons JM, Brophy PD, Blowey D, Fortenberry JD, Chand D, Flores FX, Alexander SR, Mahan JD, McBryde KD, Benfield MR, Goldstein SL. The effect of vascular access location and size on circuit survival in pediatric continuous renal replacement therapy: a report from the PPCRRT registry. Int J Artif Organs. 2007;30(2):1116–21.CrossRefGoogle Scholar
- 5.Ng YN, Ganta K, Davis H, Pankratz VS, Unruh M. Vascular access site for renal replacement therapy in acute kidney injury: a post hoc analysis of the ATN study. Front Med. 2017;4(40):1–7.Google Scholar