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Neonatal and Paediatric CRRT Procedure in Mukundapur

Neonatal and Paediatric CRRT Procedure

Neonatal and Paediatric CRRT Procedure in Mukundapur

Continuous Renal Replacement Therapy (CCRT) is a 24-hour dialysis therapy. It is used in patients suffering from fluid overload and acute kidney injury (AKI). Symptoms usually shown by children requiring CRRT include puffy or swollen faces and lab tests that show increased levels of waste products. CRRT functions in place of healthy kidneys and gently cleans the blood by removing extra fluid and waste products. This helps in maintaining the electrolytes and chemical balance in the blood. The CRRT procedure does not improve kidney functioning, but it helps with kidney function until their recovery. 

Manipal Hospitals are essential to Continuous Renal Replacement Therapy (CRRT) because we offer highly qualified medical staff and specialised equipment for renal treatment. For the treatment of fluid and electrolyte imbalances in critically ill patients suffering from acute kidney injury or other renal problems, we provide cutting-edge continuous CRRT devices. For Neonatal and Paediatric CRRT procedure in Mukundapur, Manipal Hospitals ensure 24-hour CRRT parameter monitoring and modification to meet the unique requirements of every patient, overseen by skilled intensivists and nephrologists. Throughout therapy, we put the safety and comfort of the patient first, with thorough support and information. The results for patients with severe renal diseases are greatly improved by Manipal Hospitals by incorporating CRRT into their critical care services. Neonatal and Paediatric 

FAQ's

  • Fluid overload

  • Severe imbalance of the electrolytes

  • Abnormalities in the metabolisms

  • Intoxications

  • Metabolic acidosis

  • Uraemic encephalopathy

  • Septic shock

The following are the preparations before starting the CRRT procedure:

  • Placement of the CVC Catheter: The central venous catheter (CVC) is inserted in a sterile environment, typically by a radiologist or an experienced intensive care specialist.

  • Consideration of Technical Challenges: Attention is given to any technical challenges that may arise during the procedure.

  • Patient Selection: Criteria for choosing patients, particularly paediatric ones, include:

                                        - Age, height, and weight of the child
                                        - Underlying medical conditions, such as kidney injury
                                        - Haemodynamic stability of the patient
                                        - Electrolyte levels and other relevant medical parameters
 

  • A CVC (central venous catheter) is placed into the larger veins of the child, which usually lie in the groin and neck regions.

  • The other end of the CVC is connected to a machine that circulates through the loop present outside the body. 

  • After the filtering of the blood in the machine, it is sent back to the body. 

  • Anticoagulation (preventing blood clots) plays a crucial role throughout the process, and regional anticoagulants like citrate or heparin for systemic anticoagulation can be used. The choice depends on the condition of the patient and the various risks associated with it. The coagulation parameters are regularly monitored to prevent further complications.

Your diet and fluid intake will be closely monitored by your healthcare team while on CRRT. They will carefully adjust your nutrition and fluid intake based on your specific medical condition, kidney function, and ongoing treatment needs. This monitoring ensures that your body receives the right balance of nutrients and fluids, which is crucial for supporting your overall health and aiding in the recovery process. It's important to follow the dietary guidelines provided by your healthcare team to optimise the effectiveness of CRRT and promote your well-being during treatment.
 

To monitor the working of the child's kidneys, there may be some time off the CRRT procedure. In cases where support is needed by the kidneys, the procedure is restarted, or it can be changed to haemodialysis, which is done for three to five days a week.
 

Following are the complications of CRRT.

  • Electrolyte imbalance (decreased levels of calcium and potassium)

  • Hypotension (decreased blood pressure below 20 mmHg in the initial 60 minutes after the procedure has started)

  • Catheter-related complications (infections, leakage, and malfunction)

Meeting the criteria meant for achieving a proper outcome can be done by associating with the indications.

  • The reduction in BUN (blood, urea, and nitrogen) levels.

  • In neonates with hyperammonemia, a reduction in toxic metabolite levels indicates efficacy.

  • The percentage decrease in certain levels of BUN and toxic metabolites can be calculated after 24 hours of undergoing CRRT.

  • Peritoneal Dialysis: It can be done in newborns and can be performed without using complicated technology.

  • Continuous Flow Peritoneal Dialysis: It is a procedure that is effective in improving ultrafiltration.

  • Continuous Venovenous Hemofiltration (CVVH): Temporary treatment for those who cannot tolerate Haemodialysis.

  • The main difference between Continuous Renal Replacement Therapy (CRRT) and intermittent Dialysis is that CRRT operates continuously for 24 hours and allows controlled fluid removal. Children with unstable haemodynamics can undergo CRRT.

  • Intermittent Dialysis is carried out in sessions that usually last for certain hours. Such procedures can cause established fluctuations in the levels of electrolytes and fluids.

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