The effectiveness of continuous venovenous hemofiltration in the treatment of acute crisis inborn errors of metabolism in children

Tóm tắt

Objective: To evaluate of the effectiveness of continuous venovenous hemofiltration in the treatment of acute crisis of inborn errors of metabolism at National Children’s Hospital. Subject and method: A prospective, intervention without the control group of 19 patients with an acute crisis of inborn errors of metabolism, who received continuous venovenous hemofiltration (CVVH) at the National Children’s Hospital from January 2015 to December 2017. Result: 19 patients (male: 11, female: 8), ranging from 4 days to 6 years of ages met inclusion criteria. CVVH was indicated due to hyperammonemia (7/19) or severe metabolic acidosis (12/19). Prior to CVVH, pH was: 7.08 ± 0.2 and was normalized after 24 hours; NH₃ was 1052 ± 36µmol/l and decreased to normal range after 24 hours. 19/19 patients were comatose with responde to pain, in which 18/19 were alert. 1/19 patients died. Common complications were nosocomial infection (3/19) and hypokalaemia (2/19). Conclusion: CVVH was an effective treatment for children with an acute crisis of inborn errors of metabolism, reduced hyperammonemia after 24 hours and corrected pH after 36 hours with higher survival rate and less complication.

Keywords: Inborn errors of metabolism, acute crisis, CVVH.