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title: Paediatrics - AKI & RRT tags: #FFICM notebook: 🌑-FFICM


Acute Kidney Injury

  • RIFLE
  • pRIFLE
  • KDIGO
  • Scharz

pRIFLE

It is affected by:

  • Creatinine clearance (rather than creatinine)
  • Urine Output

AKIN

  • This doesn't use GFR or baseline creatinine
  • It uses current refence creatinine and change to new
  • Plus Urine Output

Has stages 1-3

KDIGO

  • Uses creatinine and urine output
  • Has stages 1-3

AKI IN PICU

~ 30% of PICU admissions - 2/3 of these < 48hrs (with a 5% Mortality) - 1/3 of these > 48hrs (with a 17% Mortality)

Fluid Overload

  • Fluid overload of >10% is asociated with greater mortality, length of stay, length of ventilation

Furosemide

  • 0.05-0.2mg/kg/hr
  • 0.5mg/kg - 1mg/kg as bolus doses (around 3x/day)

CRRT Indications in Paeds

  • Same as adults

Heparin Aims

  • 0.3-05 for CRRT (prophylactic)
  • 0.5 for actual anticoaculation

Doses

Standard 35ml/kg/hr

High Dose 50ml/kg/hr