000			03291cam a2200349 a 4500
003			EG-GiCUC
005			20250223031953.0
008			180407s2017 ua dh f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aPh.D
099			_aCai01.11.28.Ph.D.2017.Do.C
100	0		_aDoaa Meshref Osman
245	1	0	_aContinuous veno-venous hemofiltration as an adjunctive therapy in children with severe sepsis and septic shock / _cDoaa Meshref Osman ; Supervised Fatina Ibrahim Fadel , Seham Awad Elsherbiny , Ahmed Mohamed Badr
246	1	5	_aإستخدام الغسيل الدموى البطئ المستمر كعلاج مساعد فى الأطفال الذين يعانون من التسمم الحاد و الصدمة الإنتانية
260			_aCairo : _bDoaa Meshref Osman , _c2017
300			_a167 P. : _bcharts , facsimiles ; _c25cm
502			_aThesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics
520			_aBackground and Objectives: The use of continuous renal replacement therapy (CRRT) has been evolving throughout the past years to be used as a multiple organ system support. The efficacy and therapeutic mechanisms of CRRT in improving hemodynamics, oxygenation and all other sepsis complications remains controversial. This study represents the first experience of our pediatric ICU in a resource limited setting, with the use of CRRT in hemodynamically unstable children. Patients and Methods: We conducted a parallel (controlled) interventional study on 41 children weighing {u2265} 7kg with multiple organ dysfunction syndrome (MODS) secondary to septic shock, admitted at the pediatric Intensive Care Unit of Cairo University Specialized Pediatric Hospital (CUSPH) who were either on high vasopressor support {u2265} 0.4 æg/kg/min and /or suffered from oliguria < 0.5 ml/kg/min stratified as acute kidney injury (RIFLE- Injury or worse) and /or fluid overload >10% and/or moderate or severe ARDS. Patients on regular hemodialysis or congenital heart diseases were excluded. Patients were divided into two groups, theinterventional group (N=21) who received Pulse high volume hemofiltration (PHVHF) on 60ml/kg/hour for 8 hours followed by conventional dose of Continuous veno -venous hemofiltration (CVVHF) on 35ml/kg/hour for an average total time of 72 hours and a minimum total time of 24 hours. The other group was the control group (N=20)that weremanaged according to our conventional ICU managementof system support. Patients within both groups were assessed at different time intervals: Time zero (T0) which was the time of reaching inclusion criteria and enrollment in the study for the controlgroup and time of initiation of CRRT for the interventional group, 8, 24 and 72 hours after enrollment in study
530			_aIssued also as CD
653		4	_aContinuous renal replacement therapy
653		4	_aContinuous veno venous hemofiltration
653		4	_aSeptic Shock
700	0		_aAhmed Mohamed Badr , _eSupervisor
700	0		_aFatina Ibrahim Fadel , _eSupervisor
700	0		_aSeham Awad Elsherbiny , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aShimaa _eCataloger
942			_2ddc _cTH
999			_c65788 _d65788