In this case report, we describe the use of the Aquadex™ system for ultrafiltration
therapy in the pediatric cardiac intensive care setting in a patient with fluid overload
and acute kidney injury after congenital heart surgery. The patient is an 11-year-old,
25 kg male with complex single ventricle anatomy who underwent a one and a half ventricle
repair. The patient experienced multiple organ dysfunction syndrome including acute
kidney injury in the early post-operative period secondary to low cardiac output syndrome
and tachyarrhythmia. Ultrafiltration using the Aquadex™ system was utilized to treat
fluid overload in the setting of acute kidney injury and hemodynamic instability.
Negative fluid balance was safely achieved. It was subsequently possible to wean ventilatory
and inotropic support. We conclude that the use of ultrafiltration therapy is feasible
in hemodynamically unstable pediatric patients with significant fluid overload in
the setting of acute kidney injury following congenital heart surgery.
Keywords
Ultrafiltration - acute kidney injury - congenital heart defects - heart failure -
cardiopulmonary bypass - cardiac surgery
