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Critical Care Pediatric Nephrology and Dialysis: A Practical Handbook pp 113–120Cite as

CRRT in a Sick Child

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Abstract

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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Author information

Authors and Affiliations

  1. Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA

    Timothy E. Bunchman

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  1. Timothy E. Bunchman
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Correspondence to Timothy E. Bunchman .

Editor information

Editors and Affiliations

  1. Kidney & Urology Institute, Medanta, The Medicity Kidney & Urology Institute, Gurugram, Haryana, India

    Sidharth Kumar Sethi

  2. Department of Nephrology, Cleveland Clinic Akron General Medical center and Akron Children’s Hospital, Akron, OH, USA

    Rupesh Raina

  3. Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

    Mignon McCulloch

  4. Pediatric Nephrology, Children’s Hospital of Richmond at the Virginia Commonwealth University, Richmond, VA, USA

    Timothy E. Bunchman

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Bunchman, T.E. (2019). CRRT in a Sick Child. In: Sethi, S., Raina, R., McCulloch, M., Bunchman, T. (eds) Critical Care Pediatric Nephrology and Dialysis: A Practical Handbook. Springer, Singapore. https://doi.org/10.1007/978-981-13-2276-1_11

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  • DOI: https://doi.org/10.1007/978-981-13-2276-1_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-2275-4

  • Online ISBN: 978-981-13-2276-1

  • eBook Packages: MedicineMedicine (R0)

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