{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:16Z","timestamp":1740126856009,"version":"3.37.3"},"reference-count":6,"publisher":"Georg Thieme Verlag KG","issue":"S 04","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":99,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background\u2003Fluid overload is a serious complication in the treatment of infants with extracorporeal membrane oxygenation (ECMO). Volume overload leads to prolonged ECMO therapy if left untreated. The renal replacement therapy of choice in pediatric patients is peritoneal dialysis or conventional dialysis using a \u201clarge\u201d hemofiltration machine via a Shaldon catheter or directly connected to the ECMO system. This study describes the implementation of a novel minimized hemodiafiltration (HDF) system in pediatric patients on ECMO.<\/jats:p><jats:p>Methods\u2003This retrospective analysis included 13 infants up to 5\u2009kg who underwent 15 veno-arterial (V-A) ECMO runs with HDF. A minimized HDF system is integrated into an existing ECMO system (18\u2009mL priming volume), connected post-oxygenation to the venous line, before the ECMO pump. Two infusion pumps are attached to the inlet and outlet of the hemofilter to control the HDF system.<\/jats:p><jats:p>In addition to retention values (creatine and urea) at six defined time points, flow rates, dialysis parameters, and volume withdrawal were examined, as well as the number of HDF system changes.<\/jats:p><jats:p>Results\u2003With a mean ECMO runtime of 156\u2009hours, the HDF system was utilized for 131\u2009hours. The mean blood flow through the hemofilter was 192\u2009mL\/min. The mean dialysate flow was 170 mL\/h, with a mean volume deprivation of 39\u2009mL\/h. The HDF system was changed once in seven cases and twice in three cases.<\/jats:p><jats:p>Conclusion\u2003There were no complications with the minimized HDF system in all 15 applications. It allows safe patient volume management when treating infants with ECMO, with effective elimination of urinary substances.<\/jats:p>","DOI":"10.1055\/s-0043-1766107","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T22:53:06Z","timestamp":1681167186000},"page":"e8-e12","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Minimized Hemodiafiltration for Extracorporeal Membrane Oxygenation in Infants"],"prefix":"10.1055","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-3371","authenticated-orcid":false,"given":"Nicola","family":"Kwapil","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8702-3800","authenticated-orcid":false,"given":"Andreas","family":"Teske","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-3416","authenticated-orcid":false,"given":"Sven","family":"Dittrich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Blumauer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4069-5594","authenticated-orcid":false,"given":"Michela","family":"Cuomo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5242-2630","authenticated-orcid":false,"given":"Ariawan","family":"Purbojo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2790-0418","authenticated-orcid":false,"given":"Frank","family":"M\u00fcnch","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"issue":"03","key":"ref1","first-page":"380","article-title":"Extracorporeal membrane oxygenation in congenital heart disease","volume":"9","author":"T Perry","year":"2022","journal-title":"Children (Basel)"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1055\/a-1120-7797","article-title":"Eine variante von NEV an ECMO","volume":"28","author":"A Teske","year":"2020","journal-title":"Intensiv"},{"key":"ref3","first-page":"11","article-title":"Update h\u00e4mofiltration und h\u00e4moperfusion","volume":"2","author":"F M\u00fcnch","year":"2019","journal-title":"KARDIOTECHNIK"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s00467-019-04468-4","article-title":"Fluid overload and fluid removal in pediatric patients on extracorporeal membrane oxygenation requiring continuous renal replacement therapy: a multicenter retrospective cohort study","volume":"35","author":"S M Gorga","year":"2020","journal-title":"Pediatr Nephrol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/MAT.0000000000001471","article-title":"Fluid balance management informs renal replacement therapy use during pediatric extracorporeal membrane oxygenation: a survey report from the kidney intervention during extracorporeal membrane oxygenation group","volume":"68","author":"S M Gorga","year":"2022","journal-title":"ASAIO J"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/S0140-6736(14)60799-6","article-title":"Continuous renal replacement therapy in neonates and small infants: development and first-in-human use of a miniaturised machine (CARPEDIEM)","volume":"383","author":"C Ronco","year":"2014","journal-title":"Lancet"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1766107.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T12:47:00Z","timestamp":1702212420000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1766107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":6,"journal-issue":{"issue":"S 04","published-online":{"date-parts":[[2023,3,13]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1766107","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"type":"print","value":"0171-6425"},{"type":"electronic","value":"1439-1902"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}