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Hemodialysis in Infants Under 1 Year of Age for Acute Poisoning FREE

Richard N. Fine, MD; Quentin Stiles, MD; John R. DePalma, MD; George N. Donnell, MD
[+] Author Affiliations

Received for publication April 22, 1968.

Reprint requests to 4650 Sunset Blvd, Los Angeles 90027 (Dr. Fine).


Am J Dis Child. 1968;116(6):657-661. doi:10.1001/archpedi.1968.02100020661015.
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SINCE hemodialysis was first used for the therapy of poisoning,1 many adults have been treated successfully.2 Although acute poisoning with various toxins commonly occurs in children, we have been able to find only 27 (Table 1) reported cases of hemodialysis for acute poisoning in this age group. Of these 27 children, only one was under 1 year of age.

This report describes our experience with hemodialysis, using a small Kiil dialyzer after cannulation of the superficial femoral artery and saphenous vein, in two infants (ages 7 and 10 months) with acute poisoning. In addition, the literature on hemodialysis in children for poisonings and hemodialysis in infants under 1 year of age is reviewed.

Methods  Cannulation.—The teflon-silastic cannula described by Quinton et al10 were used. Under light general anesthesia, the superficial femoral artery and saphenous vein were isolated in the femoral triangle and cannulated with No. 16

REFERENCES

Doolan, P.D., et al:  Acetysalicylic Acid Intoxication: A Proposed Method of Treatment , JAMA 146:105-106 ( (May) ) 1951;.
Maher, J.F., and Schreiner, G.E.:  Editorial Review: The Clinical Dialysis of Poisons , Trans Amer Soc Artif Intern Organs 10:385-394, 1963;.
Schreiner, G.E.:  The Role of Hemodialysis (Artificial Kidney) in Acute Poisoning , Arch Intern Med 102:896-913 ( (Dec) ) 1958;.
Spritz, N., et al:  Treatment of Salicylate Intoxication in a 2-Year-Old Child , Pediatrics 24: 540-543 ( (Oct) ) 1959;.
Clapp, W.N.; Holmes, J.; and O'Brien, D.:  Extracorporeal Hemodialysis in Children , Amer J Dis Child 104:77-84 ( (July) ) 1962;.
Walker, J.G., et al:  The Use of Hemodialysis in Acute Renal Failure and Overhydration in Children , Arch Dis Child 37:578-583 ( (Dec) ) 1962;.
Lee, H.A., and Sharpstone, P.:  Hemodialysis in Pediatrics , Acta Paediat Scand 55:529-535 ( (Sept) ) 1966;.
Hickman, R.O., and Scribner, B.H.:  Application of the Pumpless Hemodialysis System to Infants and Children , Trans Amer Soc Artif Intern Organs 8:309-314, 1962;.
Kallen, R.J., et al:  Hemodialysis in Children: Technique, Kinetic Aspects Related to Varying Body Size, and Application to Salicylate Intoxication, Acute Renal Failure, and Related Disorders , Medicine 45:1-50 ( (Jan) ) 1966;.
Quinton, W.; Dillard, D.; and Scribner, B.H.:  Cannulation of Blood Vessels for Prolonged Hemodialysis , Trans Amer Soc Artif Intern Organs 6: 104-113, 1960;.
Jorgensen, H.E., and Wieth, J.O.:  Dialyzable Poisons: Hemodialysis in the Treatment of Acute Poisoning , Lancet 1:81-84 ( (Jan) ) 1963;.
Sunshine, I., and Leonards, J.R.:  The Use of Artificial Kidney for Removal of Barbiturates in Dogs , Proc Soc Exp Biol Med 86:638-641 ( (Sept) ) 1954;.
Anderson, J.; Lee, H.A.; and Straud, C.E.:  Hemodialysis in Infants and Small Children , Brit Med J 1:1405-1408 ( (May) ) 1965;.
Moorhead, J.G.; Edwards, E.C.; and Goldsmith, J.J.:  Hemodialysis of Three Children and One Infant With a Hemolytic-Uremic Syndrome , Lancet 1:570-573 ( (March) ) 1965;.
Breakey, B.A.; Woodruff, M.W.; and Reus, W.F.:  The Adaptability of the Kolff Twin Coil Artificial Kidney for Dialysis in Infancy , J Urol 86:304-306 ( (Sept) ) 1961;.
Walker, C.H., et al:  Hemodialysis in Infantile Nephrotic Syndrome , Amer J Dis Child 106:479-483 ( (Nov) ) 1963;.
Nayman, J.:  Use of Arteriovenous Shunt for Hemodialysis in 8-Month-Old Infant , Brit Med J 2:160-161 ( (July) ) 1963;.

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References

Doolan, P.D., et al:  Acetysalicylic Acid Intoxication: A Proposed Method of Treatment , JAMA 146:105-106 ( (May) ) 1951;.
Maher, J.F., and Schreiner, G.E.:  Editorial Review: The Clinical Dialysis of Poisons , Trans Amer Soc Artif Intern Organs 10:385-394, 1963;.
Schreiner, G.E.:  The Role of Hemodialysis (Artificial Kidney) in Acute Poisoning , Arch Intern Med 102:896-913 ( (Dec) ) 1958;.
Spritz, N., et al:  Treatment of Salicylate Intoxication in a 2-Year-Old Child , Pediatrics 24: 540-543 ( (Oct) ) 1959;.
Clapp, W.N.; Holmes, J.; and O'Brien, D.:  Extracorporeal Hemodialysis in Children , Amer J Dis Child 104:77-84 ( (July) ) 1962;.
Walker, J.G., et al:  The Use of Hemodialysis in Acute Renal Failure and Overhydration in Children , Arch Dis Child 37:578-583 ( (Dec) ) 1962;.
Lee, H.A., and Sharpstone, P.:  Hemodialysis in Pediatrics , Acta Paediat Scand 55:529-535 ( (Sept) ) 1966;.
Hickman, R.O., and Scribner, B.H.:  Application of the Pumpless Hemodialysis System to Infants and Children , Trans Amer Soc Artif Intern Organs 8:309-314, 1962;.
Kallen, R.J., et al:  Hemodialysis in Children: Technique, Kinetic Aspects Related to Varying Body Size, and Application to Salicylate Intoxication, Acute Renal Failure, and Related Disorders , Medicine 45:1-50 ( (Jan) ) 1966;.
Quinton, W.; Dillard, D.; and Scribner, B.H.:  Cannulation of Blood Vessels for Prolonged Hemodialysis , Trans Amer Soc Artif Intern Organs 6: 104-113, 1960;.
Jorgensen, H.E., and Wieth, J.O.:  Dialyzable Poisons: Hemodialysis in the Treatment of Acute Poisoning , Lancet 1:81-84 ( (Jan) ) 1963;.
Sunshine, I., and Leonards, J.R.:  The Use of Artificial Kidney for Removal of Barbiturates in Dogs , Proc Soc Exp Biol Med 86:638-641 ( (Sept) ) 1954;.
Anderson, J.; Lee, H.A.; and Straud, C.E.:  Hemodialysis in Infants and Small Children , Brit Med J 1:1405-1408 ( (May) ) 1965;.
Moorhead, J.G.; Edwards, E.C.; and Goldsmith, J.J.:  Hemodialysis of Three Children and One Infant With a Hemolytic-Uremic Syndrome , Lancet 1:570-573 ( (March) ) 1965;.
Breakey, B.A.; Woodruff, M.W.; and Reus, W.F.:  The Adaptability of the Kolff Twin Coil Artificial Kidney for Dialysis in Infancy , J Urol 86:304-306 ( (Sept) ) 1961;.
Walker, C.H., et al:  Hemodialysis in Infantile Nephrotic Syndrome , Amer J Dis Child 106:479-483 ( (Nov) ) 1963;.
Nayman, J.:  Use of Arteriovenous Shunt for Hemodialysis in 8-Month-Old Infant , Brit Med J 2:160-161 ( (July) ) 1963;.

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