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Am J Perinatol 2002; 19(4): 221-224
DOI: 10.1055/s-2002-28487
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
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Publication History

Publication Date:
13 May 2002 (online)

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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

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