ABSTRACT
Summer camps, sports camps, and residential camps are readily available to children and adolescents across the country. However, children and adolescents with end stage renal disease (ESRD) may not be able to participate in summer camp experiences because of specialized medical needs (e.g., dialysis or immunosuppressive medications) and concerns about abilities to keep up with camp activities. With enhancements in pediatric nephrology care in the past 10 years, patients can be expected to attend school full time and participate in peer activities. In addition, attendance at summer camps becomes a possibility for these children, particularly camps aimed at children with ESRD. Twenty pediatric nephrology centers in North America were surveyed about their participation in summer camp programs. This article reviews these and attempts to elucidate the values of summer camp programs for pediatric ESRD patients.
Subject(s)
Camping , Kidney Failure, Chronic/nursing , Kidney Failure, Chronic/prevention & control , Adolescent , Child , Female , Humans , Kidney Failure, Chronic/psychology , Male , Nephrology , Pediatric Nursing , Self Care , Surveys and Questionnaires , United StatesABSTRACT
Peritoneal dialysis (PD) is often the preferred modality in dialyzing the pediatric patient in acute renal failure. However, PD may be contraindicated in the presence of the acute surgical abdomen, respiratory compromise, or diaphragmatic disruption. The child's size and cardiovascular instability may also render hemodialysis undesirable. The use of continuous arteriovenous hemofiltration (CAVH) has been an option for the acutely ill child but requires arterial and venous access as well as adequate blood pressure to drive the CAVH circuit. Another option is continuous venovenous hemofiltration (CVVH), which obviates the need for arterial access and provides blood flow via an external pump. This article presents a retrospective of 20 acutely ill pediatric patients who received continuous venovenous hemofiltration with and without dialysis (CVVH/D) during the period covering Fall 1992 through Fall 1993 at Children's Hospital in Seattle. The children ranged in age from 1 day to 12 years (mean age 4 years) and weights ranged from 1.7 kg to 76 kg (mean 15.8 kg). Seventeen of the 20 patients were started on CVVH/D due to hemodynamic instability, 1 for PD complications, and 2 for metabolic disorders. Fluid and solute removal were achieved efficiently and metabolic imbalances were easily corrected. Patients received 1-25 days (mean 7.7 days) of CVVH/D.
Subject(s)
Acute Kidney Injury/therapy , Hemofiltration/methods , Renal Dialysis/methods , Acute Kidney Injury/mortality , Child , Child, Preschool , Combined Modality Therapy , Hemofiltration/instrumentation , Humans , Infant , Infant, Newborn , Nursing Records , Renal Dialysis/instrumentation , Retrospective Studies , Treatment OutcomeABSTRACT
The nursing interventions necessary to care for this critically ill child were professionally challenging. Meeting the psychosocial, educational, and supportive needs of the family during this period of uncertainty, as well as, providing the dialysis therapy and support for this fragile child demonstrated the unique contributions of professional nursing. All outcomes were met, but the patient's extremely poor myocardial function made dialysis treatments and volume control difficult. The use of CVVHD was instrumental to providing dialysis in a safe, effective manner. The nursing care for S.B.K. and her family was physically and emotionally draining, but seeing her neurological status return was the great reward for all of our efforts.
