Affiliations: Department of Cardiothoracic Surgery, Division of Pediatric and Adult Congenital Cardiac Surgery, Langone Medical Center, New York, NY, USA | Department of Pediatrics, Division of Pediatric Cardiology, New York University, Langone Medical Center, New York, NY, USA
Note:  Corresponding author: Dr. Sujata B. Chakravarti, MD, NYU Langone Medical Center-Tisch Hospital, Congenital Cardiovascular Care Unit, 550 First Avenue, 15th Floor, New York, NY 10016, USA. Tel.: +1 212 263 320; Fax: +1 646 501 6803; E-mail: [email protected]
Abstract: In this case report, we describe the use of the Aquadex™ system for ultrafiltration therapy in the pediatric cardiac intensive care setting in a patient with fluid overload and acute kidney injury after congenital heart surgery. The patient is an 11-year-old, 25 kg male with complex single ventricle anatomy who underwent a one and a half ventricle repair. The patient experienced multiple organ dysfunction syndrome including acute kidney injury in the early post-operative period secondary to low cardiac output syndrome and tachyarrhythmia. Ultrafiltration using the Aquadex™ system was utilized to treat fluid overload in the setting of acute kidney injury and hemodynamic instability. Negative fluid balance was safely achieved. It was subsequently possible to wean ventilatory and inotropic support. We conclude that the use of ultrafiltration therapy is feasible in hemodynamically unstable pediatric patients with significant fluid overload in the setting of acute kidney injury following congenital heart surgery.