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Infection in critically ill pediatric patients on continuous renal replacement therapy

Infection in critically ill pediatric patients on continuous renal replacement therapy

Int J Artif Organs 2017; 40(5): 224 - 229

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ijao.5000587

Authors

Maria J. Santiago, Jesús López-Herce, Eva Vierge, Ana Castillo, Amaya Bustinza, Jose M. Bellón, Amelia Sánchez, Sarah Fernández

Abstract

Introduction

Continuous renal replacement therapies (CRRT) are frequently used in critically ill children and may increase the risk of infection. However, the incidence, characteristics and prognosis of infection in critically ill children on CRRT have not been studied.

Methods

Data from a prospective, single-center register of critically ill children treated with CRRT was analyzed.

Results

55 children (40% under 1 year of age) were treated with CRRT between June 2008 and January 2012; 43 patients (78.2%) presented 1 or more infections. The most common condition of patients requiring CRRT was heart disease (69%). Infection occurred a median of 11 days after the initiation of CRRT (IQ range: 4 to 21 days). A total of 21 patients (48.8 %) developed 1 infection, 7 (16.2%) developed 2 infections and 15 (34.9%) developed 3 or more infections. The most frequent infection was catheter-related bacteremia, with no differences in catheter location. CRRT duration longer than 4.5 days was the only risk factor for infection. Patients with infection had a longer length of stay (LOS) in the Pediatric Intensive Care Unit (PICU) than patients without it (37.8 vs. 17.6, p = 0.019), but there were no differences in mortality (30.2% vs. 33.3%; p = 0.84).

Conclusions

Infection rate is high in critically ill children treated with CRRT. More than 4 days of CRRT increases the risk of infection. Infection in these patients entails a longer stay in the PICU but did not increase mortality.

Article History

Disclosures

Financial support: This work was supported by the Carlos III Health Institute (PI12/01328): Mother-Child Health and Development Network (Red SAMID) - RETICS funded by the PN I+D+I 2008-2011 (Spain), ISCIIISub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), ref. RD12/0026 and RD16/0022.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Pediatric Intensive Care Department, Health Research Institute, Gregorio Marañón General University Hospital of Madrid, School of Medicine, Complutense University of Madrid, Madrid - Spain
  • Department of Statistics, Health Research Institute, Gregorio Marañón General University Hospital of Madrid, School of Medicine, Complutense University of Madrid, Madrid - Spain

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