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Insuffisance rénale aiguë et techniques d’épuration extrarénale en réanimation pédiatrique

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Réanimation pédiatrique

Part of the book series: Le point sur … ((POINT))

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Résumé

L’épuration extrarénale (ÉER) permet d’assurer la soustraction d’eau et de solutés qui n’est pas ou plus suffisamment assurée par les reins : l’insuffisance rénale aiguë (IRA) reste ainsi l’indication la plus ancienne, et ce, quel que soit l’âge des patients [1]. D’autres indications pédiatriques reconnues ne seront pas évoquées dans ce chapitre et recouvrent les maladies héréditaires du métabolisme, les troubles ioniques menaçants, l’insuffisance cardiaque réfractaire (typiquement après chirurgie cardiaque), le traitement voire la prévention des conséquences métaboliques des lyses tumorales, certaines intoxications ou encore les hypothermies accidentelles profondes. Enfin, d’autres situations (choc septique, pancréatites aiguës) restent à ce jour des indications controversées, l’ÉER n’ayant pas fait la preuve d’une diminution significative de la mortalité en dehors des cas associés à une IRA [2–4]. Quoi qu’il en soit, la connaissance des principales techniques actuellement disponibles chez l’enfant et tout particulièrement chez le nourrisson de petit poids, de leurs avantages et leurs inconvénients respectifs, permet au réanimateur-pédiatre de choisir au mieux celle qui, pour un patient donné, à un moment donné, sera la plus efficace et la moins risquée.

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Références

  1. Kramer P, Wigger W, Rieger J, et al. (1977) Arteriovenous haemofiltration: a new and simple method for treatment of over-hydrated patients resistant to diuretics. Klin Wochenschr 55: 1121–2

    Article  PubMed  CAS  Google Scholar 

  2. Goldstein SL, Somers MJ, Baum MA, et al. (2005) Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy. Kidney Int 67: 653–8

    Article  PubMed  Google Scholar 

  3. Walters S, Porter C, Brophy PD (2009) Dialysis and pediatric acute kidney injury: choice of renal support modality. Pediatr Nephrol 24: 37–48

    Article  PubMed  Google Scholar 

  4. Brophy PD (2008) Renal supportive therapy for pediatric acute kidney injury in the setting of multiorgan dysfunction syndrome/sepsis. Semin Nephrol 28: 457–69

    Article  PubMed  Google Scholar 

  5. Moghal NE, Brocklebank JT, Meadow SR (1998) A review of acute renal failure in children: incidence, etiology and outcome. Clin Nephrol 49: 91–5

    PubMed  CAS  Google Scholar 

  6. Flynn JT (2002) Choice of dialysis modality for management of pediatric acute renal failure. Pediatr Nephrol 17: 61–9

    Article  PubMed  CAS  Google Scholar 

  7. Andreoli SP (2009) Acute kidney injury in children. Pediatr Nephrol 24: 253–63

    Article  PubMed  Google Scholar 

  8. Hui-Stickle S, Brewer ED, Goldstein SL (2005) Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001. Am J Kidney Dis 45: 96–101

    Article  PubMed  Google Scholar 

  9. Bagshaw SM, George C, Bellomo R (2008) A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients. Nephrol Dial Transplant 23: 1569–74

    Article  PubMed  Google Scholar 

  10. Bellomo R, Ronco C, Kellum JA, et al. (2004) Acute renal failure — definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8: R204–12

    Article  PubMed  Google Scholar 

  11. Akcan-Arikan A, Zappitelli M, Loftis LL, et al. (2007) Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 71: 1028–35

    Article  PubMed  CAS  Google Scholar 

  12. Goldstein SL (2006) Pediatric acute kidney injury: it’s time for real progress. Pediatr Nephrol 21: 891–5

    Article  PubMed  Google Scholar 

  13. Bagshaw SM, Cruz DN, Gibney RT, Ronco C (2009) A proposed algorithm for initiation of renal replacement therapy in adult critically ill patients. Crit Care 13: 317

    Article  PubMed  Google Scholar 

  14. Strazdins V, Watson AR, Harvey B (2004) Renal replacement therapy for acute renal failure in children: European guidelines. Pediatr Nephrol 19: 199–207

    Article  PubMed  Google Scholar 

  15. Lacroix J (2007) Urgences et soins intensifs pédiatriques, 2e édition, CHU Sainte Justine, Montréal.

    Google Scholar 

  16. Goldstein SL (2009) Overview of pediatric renal replacement therapy in acute kidney injury. Semin Dial 22: 180–4

    Article  PubMed  Google Scholar 

  17. del Castillo J, Lopez-Herce J, Cidoncha E, et al. (2008) Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study. Crit Care 12: R93

    Article  PubMed  Google Scholar 

  18. Cruz D, Bobek I, Lentini P et al. (2009) Machines for continuous renal replacement therapy. Semin Dial 22: 123–32

    Article  PubMed  Google Scholar 

  19. Morita Y, Johnson RW, Dorn RE, Hall DS (1961) Regional anticoagulation during hemodialysis using citrate. Am J Med Sci 242: 32–43

    Article  PubMed  CAS  Google Scholar 

  20. Klingel R, Schaefer M, Schwarting A, et al. (2004) Comparative analysis of procoagulatory activity of haemodialysis, haemofiltration and haemodiafiltration with a polysulfone membrane (APS) and with different modes of enoxaparin anticoagulation. Nephrol Dial Transplant 19: 164–70

    Article  PubMed  CAS  Google Scholar 

  21. Sy O, Rolin N, Monchi M (2009) Anticoagulation en épuration extrarénale. Réanimation 18: 376–85

    Article  Google Scholar 

  22. Bonilla-Felix M (2009) Peritoneal dialysis in the pediatric intensive care unit setting. Perit Dial Int 29: S183–5

    PubMed  Google Scholar 

  23. Ronco C, Garzotto F, Ricci Z (2012) CA.R.PE.DI.E.M. (Cardio-Renal Pediatric Dialysis Emergency Machine): evolution of continuous renal replacement therapies in infants. A personal journey. Pediatr Nephrol 27(8): 1203-11

    Google Scholar 

  24. Alkandari O, Eddington KA, Hyder A, et al. (2011) Acute kidney injury is an independent risk factor for pediatric intensive care unit mortality, longer length of stay and prolonged mechanical ventilation in critically ill children: a two-center retrospective cohort study. Crit Care 15(3): R146

    Article  PubMed  Google Scholar 

  25. Schneider J, Khemani R, Grushkin C, Bart R (2010) Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit. Critical Care Medicine 38(3): 933-9

    Article  PubMed  CAS  Google Scholar 

  26. Herrero-Morin JD, Malaga S, Fernandez N, et al. (2007) Cystatin C and beta2-microglobulin: markers of glomerular filtration in critically ill children. Crit Care 11(3): R59

    Article  PubMed  Google Scholar 

  27. Hayes LW, Oster RA, Tofil NM, et al. (2009) Outcomes of critically ill children requiring continuous renal replacement therapy. J Crit Care 24(3): 394–400

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de réanimation et surveillance continue pédiatriques, Pôle de pédiatrie aiguë et médecine interne, AP-HP et université Paris-Diderot, Sorbonne Paris-Cité, Hôpital Robert-Debré, 48, boulevard Sérurier, 75019, Paris, France

    S. Aizenfisz & S. Dauger

  2. Service de néphrologie pédiatrique, Pôle de pédiatrie spécialisée, AP-HP et université Paris-Diderot, Sorbonne Paris-Cité, Hôpital Robert-Debré, 48, boulevard Sérurier, 75019, Paris, France

    M.-A. Macher

  3. Service de soins intensifs pédiatriques, Hôpital Sainte-Justine, 3175, rue de la Côte Sainte-Catherine, Montréal, Québec, H3T 1C5, Canada

    P. Jouvet

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  1. S. Aizenfisz
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  2. M.-A. Macher
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  3. P. Jouvet
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  4. S. Dauger
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Correspondence to S. Aizenfisz .

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Aizenfisz, S., Macher, MA., Jouvet, P., Dauger, S. (2013). Insuffisance rénale aiguë et techniques d’épuration extrarénale en réanimation pédiatrique. In: Réanimation pédiatrique. Le point sur …. Springer, Paris. https://doi.org/10.1007/978-2-8178-0407-1_6

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  • DOI: https://doi.org/10.1007/978-2-8178-0407-1_6

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0406-4

  • Online ISBN: 978-2-8178-0407-1

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