In recent years more sophisticated RRT techniques have developed, particularly in adult intensive care, which have been adapted by paediatric units. This gives greater opportunity for tailoring treatment to the individual patient. However we are handicapped by the lack of data on the efficacy of different therapies, particularly in children.
Peritoneal dialysis (PD) is still the most popular dialysis option in children. It is simple and relatively inexpensive, providing adequate removal of fluid and solute.
An increasingly popular form of RRT is haemofiltration, particularly continuous veno-venous haemofiltration (CVVH). It has the advantage over intermittent haemodialysis, of bringing about a gradual correction of fluid and electrolytes and is particularly useful in haemodynamically unstable patients. Fluid removal is more predictable than with PD. However the need for systemic anticoagulation in an extracorporeal circuit and the reliance on specialist equipment and nursing staff, may restrict its use.
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