Continuous renal replacement therapy in extremely low birth weight infants: a series of 5 cases

Abstract

Background

Continuous renal replacement therapy (CRRT) plays a pivotal role in delivering renal support to critical patients with acute kidney injury (AKI). However, administering CRRT to extremely low birth weight (ELBW) infants, defined as those with a birth weight under 1000 g, presents distinct challenges. We summarized our experiences of the ELBW infants who were treated with CRRT at a tertiary medical center in China, and evaluated its feasibility and safety in this group of patients.

Methods

ELBW infants were performed CRRT at the neonatal intensive care unit (NICU), the Third Xiangya Hospital of Central South University, a tertiary medical center in China, between 2021 and 2023.

Results

A total of 5 ELBW infants with a minimum birth weight of 450 g were involved in this study. At the commencement of CRRT, four patients still weighed less than 1000 g, with the lowest being 700 g. We placed a 5.0Fr double-lumen catheter in the internal jugular vein or femoral vein under ultrasound guidance. The extracorporeal circuit was primed with compatible blood. CRRTs were successfully initiated in all patients. Four patients completed CRRT as planned, and the maximum cumulative CRRT time was 65 h. Only two patients were still alive at 28-day, but eventually dropped out of treatment for severe neurological sequelae.

Conclusions

This is the first research of ELBW infants’ CRRT in China. Our findings indicate that CRRT may be feasible in ELBW infants, but improving the survival rate and long-term prognosis remains a challenge in those newborns undergoing such procedure.