To Analysis The Relevant Factors With Complication Of CVVH In Pediatric Critical Patients

Objectives:To investigate the complications of continuous veno-venous hemofiltration(CVVH)in treating pediatric critical care patients and their related factors,which may supply foundation and guidance for the prophylaxis of theses complications.Methods:The clinical data of patients who treated with CVVH in the pediatric intensive care unit(PICU)of the Children's Hospital of Zhejiang University School of Medicine during January 1st 2013 and July 31st 2017 were collected.The patients' age,gender,primary diseases,the body temperature,blood pressure,electrolyte and unexpected halt during CVVH were analyzed.The associations between the complication of CVVH and their relevant factors were performed using Spearman rank correlation analysis.All the data were performed by SPSS 22.0 and P value less than 0.05 was considered to be statistically significance.Results:A total of 84 patients who underwent 136 episodes of CVVH were enrolled.The ratio of male to female was 1.5.The median age was 7.8 years old with a range of 2 months to 14 years.The median body weight was 24.2kg(range:5.85-63kg).Of these patients,63.09%(53/84)received CWH due to renal failure.As to the complications,decrease of body temperature occurred in 1.5%(42/84)episodes,with a median decrease of 1.27?.The occurrence of temperature decrease and the range of decrease were both related to the age and body weight(P value all<0.05).The elevation of blood glucose was observed in 70 episodes(83.33%)of CVVH,with a median increase of 8.95mmol/L.The elevation of blood glucose was associated with the total duration of CWH(P=0.037),age(P=0.031)and body weight(P=0.018).The electrolyte disturbance was found in 66 episodes(78.57%)of CWH,which was related to body weight(P=0.030).The unexpected halt of machine occurred in 54 episodes(64.28%),including 46(85.18%)due to abnormal venous pressure or thrombin in the pipeline because of hypercoagulability,7 due to severe hemorrhage,1 due to severe hypotension.Conclusions:The common complications of CVVH in treating pediatric critical care patients includes decrease of body temperature,elevation of blood glucose,electrolyte disturbance and unexpected halt of the machine.The body weight and age were associated with the change of temperature and glucose,while the abnormality of glucose and electrolyte was related to the duration of CVVH and the body weight.