CME Live: Hyperammonaemia and CRRT in acute liver failure
Dr. Timothy Buchman
Curofy- India's largest community of verified doctors covered the CME-International Neonatal and Pediatric Nephrology Training Workshop live. This post was first published on the Curofy app.
Indication of RRT in ALF
Hepatic encephalopathy grade 3-4
Renal dysfunction
Metabolic abnormalities
No one indication is an absolute one in for initiation of RRT
RRT in CLD
Supportive therapy for kids who deteriorate
Volume overload, intractable metabolic acidosis, and hyperkalemia
Delay in RRT decreases mortality by 90%
Serves as a bridge to transplant
Modalities:
CRRT-CVVH, CVVHD CVVHDF- no evidence which was bettter
TPE- therapeutic plasma exchange
MARS
SPAD: single pass albumin dialysis
No evidence for RRT in liver patients
Should we undertake CRRT in ALF?
Yes and review
For neuroprotection, metabolic disarray, bridge for recovery or transplant
CRRT- unstable
TPE- the way to go
Dose: No evidence in pediatrics, High is gaining popularity
Anticoagulation: PGI2 and low dose heparin
Dr. Timothy Buchman
Curofy- India's largest community of verified doctors covered the CME-International Neonatal and Pediatric Nephrology Training Workshop live. This post was first published on the Curofy app.
Indication of RRT in ALF
Hepatic encephalopathy grade 3-4
Renal dysfunction
Metabolic abnormalities
No one indication is an absolute one in for initiation of RRT
RRT in CLD
Supportive therapy for kids who deteriorate
Volume overload, intractable metabolic acidosis, and hyperkalemia
Delay in RRT decreases mortality by 90%
Serves as a bridge to transplant
Modalities:
CRRT-CVVH, CVVHD CVVHDF- no evidence which was bettter
TPE- therapeutic plasma exchange
MARS
SPAD: single pass albumin dialysis
No evidence for RRT in liver patients
Should we undertake CRRT in ALF?
Yes and review
For neuroprotection, metabolic disarray, bridge for recovery or transplant
CRRT- unstable
TPE- the way to go
Dose: No evidence in pediatrics, High is gaining popularity
Anticoagulation: PGI2 and low dose heparin
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