Nephrology

126 Guidelines For Paediatric Haemodialysis

  • Guidelines For Paediatric Haemodialysis  

    Extracorporeal Circuit

    Circuit volume must be less than 8-10% of child's blood volume.  Blood volume = 80ml/kg

    Formula for 10% of child's blood

    Body weight (in Kg) x 80/10

    The extracorporeal circuit is composed of arterial and venous blood lines and dialyser.  This can be chosen from the available lines and dialysers, and will be largely dependent on priming volume

    Lines and dialysers Available at Royal Children's Hospital

    Dialyser Performance Summary

     Dialyser Membrane SA (m2)Kuf in vitro (ml/h r/mmHg)  Urea clearance (BFR 200) Urea Clearance (BRF 300) Creatinine Clearance BFR (200)PO4 Colearance (BRF 200) Vitamin B12 Clearance (BFR 200)Inulin Priming Volume (mls) 
    F3(ETO)polysulfone 0.41.7125?955020 -28
    F4 HPS (steam)polysulfone 0.74.31601901319550-42
    F6 HPS (steam)polysulfone 1.38.51832371671408082
    F7 HPS (steam)polysulfone 1.69.8186240172 15090-102
    F60Spolysulfone1.64.0185-1721701188882
    FX PaedHelixone0.2m2

    7

    Urea (100ml) 76    

    -Creatinine clearance     (100ml) 64  PO4 clearance (100ml)  57Vitamin B12 Clearance (100ml) 54  2018
    FX 40Helixone0.6m220170-144138845432
    FX 60Helixone1.4m2461932611821771359574
    FX80Helixone1.8m25919727618918514811295
    140 HPolyamix1.4m2601932621811741289194
    170 HPolyamix1.7m270196270186180137100115

    Blood Lines

    SizeVolume and 7 West Stock Numbers
    Gambro - Neonatal lines/Very Small Paediatrics27.5mls (A 5.128.84 V5.127.X)
    Gambro - Paediatric lines77mls (A122-B6WS2 V5107.X)
    Gambro - Adult lines130mls (GE2W)
    Gambro - Paediatric Double Pump Single Needle lines106mls (A5216-B6WS2 V5.213-B6X WS2)
    Fresenius Neonatal 50ml Order No: 6014601
    Fresenius Paed111ml Order No: 6014611
    Fresenius Paed137ml Order No: 6014621


    Example:  

    A 10kg child 
    10% of blood volume =  10 x 80/10 = 80mls      

    i.e.: Extra corporeal circuit volume must not exceed 80mls, this includes any pre-dialysis blood taken. 

    In this example, choose neonatal lines in combination with an F3 dialyser

    The volume of this circuit is 27.5mls + 28mls = 55mls

    If the infant is small (<7.5kg) consider using a blood prime

    Anticoagulation guidelines refer to Anticoagulation for Haemodialysis Protocol