Continuous Venovenous Hemodiafiltration in Neonatal Onset Hyperammonemia

Takehiko Hiroma; Tomohiko Nakamura; Masanori Tamura; Tsuyoshi Kaneko; Atsushi Komiyama

doi:10.1055/s-2002-28487

American Journal of Perinatology, Table of Contents

Am J Perinatol 2002; 19(4): 221-224
DOI: 10.1055/s-2002-28487

Continuous Venovenous Hemodiafiltration in Neonatal Onset Hyperammonemia

Takehiko Hiroma¹ , Tomohiko Nakamura¹ , Masanori Tamura¹ , Tsuyoshi Kaneko¹ , Atsushi Komiyama²

¹Division of Neonatology, Medical Engineering, Nagano Children's Hospital, Nagano, Japan
²Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan

Abstract

ABSTRACT

We report on four cases of neonatal-onset hyperammonemia due to metabolic disorders treated with continuous hemodiafiltration (CHDF). CHDF accomplished prompt removal of serum ammonia under very stable circulation. To overcome the various difficulties of blood purification procedures to the neonate, we used: (1) a 7-Fr double lumen catheter from the internal jugular vein to the atrium to perform the procedure veno-venously, (2) a special circuit for neonates, (3) nafamostat mesilate as an anticoagulant, and (4) a circuit warmer. The serum ammonium level decreased under 200 μg/dL within 30 hours and lactic acidosis were corrected immediately. We conclude that CHDF is an extremely effective and safe treatment for fluminant neonatal-onset hyperammonemia due to metabolic disorders.

KEYWORDS

Neonate - hyperammonemia - continuous hemodiafiltration

Full Text

References

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