University Hospital of Wales Paediatric Intensive Care Unit Guideline Printed on Wed 23-jul-08
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Last updated June 9, 2014 10:10 AM

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University Hospital of Wales Heath Park
Cardiff
CF14 4XW
02920 747747

Continuous Veno-Venous Filtration

Nikki Reynolds and Julie Armstrong have produed the following documents to guide staff in setting up and prescribing CVVH.

Guide to blood flow rates and substitution rates

Haemofiltration Guidelines

Prescription sheet

Please use the sheet below to prescribe haemofiltration.

Prescription for CVVH

Drug doses in CVVH

Although there is guidance in the BNF-C on adjusting drug doses for different degrees of renal impairment there is no standard reference source to find accurate dose adjustments for drugs when patients are on CVVH. The following information is based on work in adults and the principals applied to children bearing in mind that it is important to consider the risk of preserving renal function at the expense of the child surviving.

Drug

Route

Recommended dose on CVVH

Aciclovir

IV

Use 100% of normal dose every 12 hours

Amiodarone

IV/PO

Dose as normal renal function

Amoxicillin

IV

Dose as normal renal function

Ambisome

IV

Dose as normal renal function

Atracrium

IV

Dose as normal renal function

Benzylpenicillin

IV

Dose as normal renal function

Cefotaxime

IV

Dose as normal renal function

Ceftazidime

IV

 > 1 month :100% of normal dose every 12 hours

Chloral hydrate

Po/PR

Start with 25mg/Kg and increase if needed

Ciprofloxacin

IV

Dose as normal renal function

Clarithromycin

Po/IV

Dose as normal renal function

Clindamycin

IV/PO

Dose as normal renal function

Clonidine

IV/PO

Dose as normal renal function

Co-amoxiclav

IV

100% dose every 12 hourly

Co-trimoxazole

IV

Normal dose & frequency for 3 days then reduce dose to 50%

Erythromycin

IV/Po

Dose as normal renal function

Flucloxacillin

IV/Po

Dose as normal renal function

Fluconazole

IV

Dose as normal renal function

Furosemide

IV

Dose as normal renal function (NB bigger doses may be needed)

Gentamicin

IV

<1 month. Give 4mg/Kg and check level at 24 hours.
>1 month < 12 years. Give 5mg/Kg & check levels at 18 – 24 hours
>12 years. Give 5mg/Kg & check levels at 18 – 24 hours
NB always wait before levels are back before giving next dose

Hydrocortisone

IV

Dose as normal renal function

Linezolid

IV

Dose as normal renal function

Meropenem

IV

Use normal dose & frequency  but do not exceed 20mg/Kg/dose if less than 50Kg or 1g 8 hourly if over 50Kg.

Metronidazole

IV

Dose as normal renal function

Omeprazole

IV/PO

Dose as normal renal function

Ondansetron

IV

Dose as normal renal function

Oseltamivir
(Treatment dose)

PO

100% of the normal dose every 24 hours

Oseltamivir
(Prophylaxis)

PO

100% of the normal dose every 48 hours

Phenytoin

IV

Dose as normal renal function

Ranitidine

IV

Dose as normal renal function

Rifampicin

IV

Dose as normal renal function

Tazocin

IV

Dose as normal renal function

Vancomycin

IV

All ages. Give 15mg/Kg and check level at 24 hours Do not give dose until level < 10mg/L
NB always wait for levels before giving the next dose.

Vecuronium

IV

Dose as normal renal function

Zoe Taylor Dec 2010