Blood Purification for Paediatric Patients.

Abstract

Background: Recent technical and experimental advances in extracorporeal blood purification therapy (eBPT) can be applied in paediatric patients, including neonates. However, there are several specific issues in performing eBPT in paediatric patients in regard to the safety and effectiveness of treatments. The aim of this review is to explore the technical aspects of acute paediatric eBPT, especially regarding renal replacement therapy and the present situation in Japan.

Summary: In children requiring eBPT, especially small children and neonates, it is difficult to secure sufficient blood flow to obtain optimal treatment effects for various diseases and critical illnesses. In such conditions, it should be considered which modalities of eBPT and anticoagulants are used and how optimal blood flow and replacement fluid/dialysate flow rate should be chosen for the safety and effectiveness of treatments. Key Messages: In paediatric patients requiring eBPT, frequent complications are observed; therefore, we should apply optimal eBPT depending on the pathophysiological conditions of paediatric patients, develop a deep understanding about paediatric eBPT, and collect evidence on treatment outcomes. In addition, the eBPT systems and devices specifically for small children are expected to be developed in Japan to improve the safety and efficacy of eBPT.