Volume 27, Issue 3 pp. 562-570
ORIGINAL ARTICLE

Characteristics of pediatric continuous renal replacement therapies in hospitals with pediatric intensive care units in Japan

Taiki Haga

Corresponding Author

Taiki Haga

Department of Pediatric Critical Care Medicine, Osaka City General Hospital, Osaka, Japan

Correspondence

Taiki Haga, Department of Pediatric Critical Care Medicine, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima, Osaka 534-0021, Japan.

Email: [email protected]

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Kentaro Ide

Kentaro Ide

Department of Critical Care and Anesthesia, National Center for Child Health and Development, Tokyo, Japan

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Masanori Tani

Masanori Tani

Department of Intensive Care Medicine, Saitama Prefectural Children's Medical Center, Saitama, Japan

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First published: 12 December 2022

Abstract

Introduction

Information on the implementation of continuous renal replacement therapy (CRRT) in pediatric intensive care units (PICUs) is limited. We investigated the real-world practice of this therapy in Japan.

Methods

We conducted a cross-sectional survey of 26 hospitals with PICUs in Japan. One physician per hospital responded to the questionnaire.

Results

Fewer than half of the hospitals followed the CRRT practice guidelines; treatment options were often selected at a physician's discretion. PICUs varied widely in continuous renal replacement settings, circuit priming methods, frequency of circuit exchange, and policies for using CRRT in sepsis. Only two anticoagulants were used: nafamostat mesylate and unfractionated heparin. Most units did not change the nutritional dosage according to CRRT use. Many facilities were proactive concerning rehabilitation.

Conclusion

Nafamostat-centered anticoagulation management was unique to Japan. Our results may help identify areas where additional clinical studies are needed to standardize CRRT practice.

CONFLICT OF INTEREST

The authors declare no conflicts of interest associated with this manuscript.

DATA AVAILABILITY STATEMENT

The data presented in this study can be shared by the corresponding author upon reasonable request.

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