scholarly journals Successful Use of Extracorporeal Life Support and Continuous Renal Replacement Therapy in the Treatment of Cardiogenic Shock Induced by Tumor Lysis Syndrome in a Pediatric Patient With Lymphoma: A Case Report

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhulin Wang ◽  
Fang Zhang ◽  
Long Xiang ◽  
Yinyu Yang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Renal Replacement Therapy ◽  
Cardiopulmonary Resuscitation ◽  
Cardiogenic Shock ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Tumor Lysis Syndrome ◽  
Electrolyte Imbalance ◽  
Tumor Lysis ◽  
Critical Ultrasound

The use of extracorporeal membrane oxygenation (ECMO) in the treatment of cardiopulmonary failure in children with malignant tumors is controversial. There are few reports on the use of ECMO in the treatment of children with tumor lysis syndrome. This article reports a case of a 9-year-old girl who presented with hyperkalemia and cardiogenic shock. The discovery of an abdominal mass with critical ultrasound provided key evidence for the initial diagnosis of tumor lysis syndrome. Cardiopulmonary resuscitation was performed for 1 h. Veno-arterial ECMO was installed at the bedside to provide cardiopulmonary support for the patient and was combined with continuous renal replacement therapy (CRRT) to improve her internal environment. The patient was ultimately diagnosed with mature B-cell lymphoma with tumor lysis syndrome. A severe electrolyte disorder led to cardiogenic shock. After the electrolyte imbalance was corrected, the patient's heart function gradually improved, ECMO was successfully weaned, and chemotherapy was continued with the support of CRRT. One month after ECMO weaning, the organ function of the patient had recovered and there were no serious complications. In this case report, we paid attention to the rapid diagnosis of the etiology behind a patient's shock with critical ultrasound as well as the initiation and management of extracorporeal cardiopulmonary resuscitation (ECPR), which provided us with valuable experience using VA-ECMO on critically ill children with tumors. It is also important evidence for the use of ECMO in the treatment of children with cardiopulmonary arrest secondary to malignancy.

Continuous Hemodiafiltration in Children

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 819-823
Author(s):  
Nancy A. Bishof ◽  
Thomas R. Welch ◽  
C. Frederic Strife ◽  
Frederick C. Ryckman
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Effective Means ◽  
Tumor Lysis Syndrome ◽  
Intermittent Hemodialysis ◽  
Tumor Lysis ◽  
Continuous Arteriovenous Hemofiltration

Continuous arteriovenous hemofiltration is a form of renal replacement therapy whereby small molecular weight solutes and water are removed from the blood via convection, alleviating fluid overload and, to a degree, azotemia. It has been used in many adults and several children. However, in patients with multisystem organ dysfunction and acute renal failure, continuous arteriovenous hemofiltration alone may not be sufficient for control of azotemia; intermittent hemodialysis or peritoneal dialysis may be undesirable in such unstable patients. Recently, the technique of continuous arteriovenous hemodiafiltration has been used in many severely ill adults. We have used continuous arteriovenous hemodiafiltration in four patients at Children's Hospital Medical Center. Patient 1 suffered perinatal asphyxia and oliguria while on extracorporeal membrane oxygenation. Patients 2 and 4 both had Burkitt lymphoma and tumor lysis syndrome. Patient 3 had septic shock several months after a bone marrow transplant. All had acute renal failure and contraindications to hemodialysis or peritoneal dialysis. A blood pump was used in three of the four patients, while spontaneous arterial flow was adequate in one. Continuous arteriovenous hemodiafiltration was performed for varying lengths of time, from 11 hours to 7 days. No patient had worsening of cardiovascular status or required increased pressor support during continuous arteriovenous hemodiafiltration. The two survivors (patients 2 and 4) eventually recovered normal renal function. Continuous arteriovenous hemodiafiltration is a safe and effective means of renal replacement therapy in the critically ill child. It may be ideal for control of the metabolic and electrolyte abnormalities of the tumor lysis syndrome.

Abstract 202: Fast Hypothermia Induced by Continuous Renal Replacement Therapy Alleviates Systemic Inflammation and Intestinal Injury After Cardiopulmonary Resuscitation in Swine

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Jiefeng Xu ◽  
Qijiang Chen ◽  
Xiaohong Jin ◽  
Chunshuang Wu ◽  
Zilong Li ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Cardiopulmonary Resuscitation ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Systemic Inflammation ◽  
Serum Levels ◽  
Multiple Organ ◽  
Intestinal Injury ◽  
Surface Cooling ◽  
Fatty Acid Binding

Introduction: Systemic inflammation and intestinal injury contribute to post-resuscitation multiple organ dysfunction and death in cardiac arrest victims, and they can be partly alleviated by therapeutic hypothermia. Recently, continuous renal replacement therapy (CRRT) was shown to be an effective cooling method to induce fast hypothermia. In this study, we investigated the effects of CRRT cooling (CRRT-C) on systemic inflammation and intestinal injury after cardiopulmonary resuscitation (CPR) in swine. Hypothesis: Fast hypothermia induced by CRRT-C would alleviate post-resuscitation systemic inflammation and intestinal injury better than surface cooling (SC). Methods: Twenty-seven male domestic swine weighing 36 ± 2 kg were utilized. Ventricular fibrillation was induced for 8 mins while defibrillation was attempted after 5 mins of CPR. At 5 mins after resuscitation, the animals were randomized to receive either CRRT-C, SC or normotherma (NT). In the two hypothermic groups, the animals were cooled by either the combination of 8-hr CRRT and 16-hr SC or the whole 24-hr SC. In animals treated with CRRT-C, a higher rate of 180 ml/min of blood flow was initially set with the infusion line submerged in 4 °C of ice water. The temperature was normally maintained in the NT group. Results: After resuscitation, the rate of temperature decrease was significantly faster in the CRRT-C group than in the SC group (9.8±1.6 vs. 1.5±0.4 °C/h, p <0.01). The serum levels of tumor necrosis factor-α, interleukin-6, intestinal fatty acid binding protein and diamine oxidase after resuscitation were significantly lower in the two hypothermic groups compared with the NT group. However, post-resuscitation systemic inflammation and intestinal injury were further significantly alleviated in the CRRT-C group compared to the SC group (Table). Conclusion: Fast hypothermia induced by CRRT-C was superior to SC in alleviating post-resuscitation systemic inflammation and intestinal injury.

scholarly journals Continuous renal replacement therapy rescues severe haemorrhagic fever with renal syndrome in pregnancy: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiang Ying ◽  
Xiaoli Lai ◽  
Xiaoxiao Jin ◽  
Linghong Cai ◽  
Xiaotian Li
Keyword(s):  
Pregnant Woman ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Electrolyte Imbalance ◽  
Comprehensive Treatment ◽  
Coagulation Disorder ◽  
Upper Respiratory Tract ◽  
Haemorrhagic Fever ◽  
Epidemic Disease

Abstract Background Haemorrhagic fever with renal syndrome (HFRS) is a natural epidemic disease caused by various types of viruses of the genus Hantavirus, which are mainly transmitted by contact with the infected rodents and their droppings. Pregnancy complicated with HFRS is rare; however, adverse maternal and foetal outcomes may be noted. In this report, we describe a case involving a pregnant woman with HFRS who was in a state of multiple organ dysfunction syndrome (MODS) and was successfully treated with continuous renal replacement therapy (CRRT). Case presentation A 32-year-old pregnant woman at 29 weeks of gestation was hospitalised for a fever and upper respiratory tract infection due to HFRS in winter. Persistent fever, coagulation disorder, thrombocytopenia, electrolyte imbalance, abnormal liver function, and renal failure were noted during the progression of the disease. The patient was treated with CRRT. She recovered after 21 days, and delivered a live infant by caesarean section at 38 weeks of gestation. Furthermore, obvious abnormalities were not detected during the follow-up of the mother and infant at 42 days, 3 months, 6 months, and 1 year after the delivery. Conclusions Early diagnosis, timely application of CRRT, and comprehensive treatment may be essential for the successful treatment of patients with HFRS during pregnancy.

1151: Safety and Efficacy of Renal Replacement Therapy for Acute Kidney Injury in Tumor Lysis Syndrome

2020 ◽  
Vol 49 (1) ◽  
pp. 577-577
Author(s):  
Sidra Ishaque ◽  
Anwar Haque ◽  
Abdul Rahim Ahmed ◽  
Farhana Amanullah ◽  
Faiza Rehman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Safety And Efficacy ◽  
Tumor Lysis
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