Welcome from

PCRRT Foundation, Inc

&

Dear Tim,

as far as I know this is the first patient treated with CAVH in the world. We performed this treatment in Vicenza in 1984 and the patient survived. After that we published the first series of 4 newborns treated with CAVH (Kidney

International 1986) . You made a great deal of progress since then and even more with this meeting. Best Wishes Claudio Ronco

Time and Transition

1984-Ronco’s KI paper 1990-CAVH becomes more common 1993-CVVH with adapted machinery 1995-automated CVVH(D) machinery 1997-ultrafiltration controllers with

automated machinery 1999-Thermic controls with automated

machinery

Time and Transition 2000-1st International Conference on Pediatric

Continuous Renal Replacement Therapy 2001-1st FDA approved Bicarbonate Based

Dialysate (Normocarb) 2001-ppCRRT Registry establishment (Stu

Goldstein) 2001-Goldstein data on FO and outcome 2002-Citrate anticoagulation 2002-PCRRT 2

Time and Transition

2002-PEDCRRT list serve Gambro releases Prismasate 2003-DiCarlo data on early intervention in

Bone Marrow Transplantation 2004-Foland data on FO and outcome 2004-Data emerging on Pharmacy Errors 2004-PCRRT 3

Time and Transition

2005 Data on Biomarkers emerging

Work by Devarajan and colleagues Data on citrate NDT Brophy et al Kidney International paper confirming now

with multicenter data on fluid overload 2006 PCRRT goes to Europe!

Successful meeting in Zurich, Sw

Time and Transition

2007/2008 Hackbarth et al multicenter data vascular

access Flores et al multicenter data AKI in the BMT

popultation Gambro is allowed to release Prismaflex

after embargo PCRRT 5

DIALYSIS MODALITY

0

10

20

30

40

50

60

HD PD CRRT

Belsha et al., Pediatr Nephrol, 1995

Pat

ien

ts (

%)

Pediatric Choice of RRT

0

10

20

30

40

50

60

1992 1994 1996 1998 2000 2002

PD

HD

CRRT

# o

n R

RT

/yr

Year of RRT

Why has this become common? Work in vascular access Dedicated staff who is interested in these

children Patients continue to be sicker then

historically Automated machinery has made the care

easier Anticoagulation protocols have made it easier

CRRT: Who does it?

Outside of NA > 70% of all CRRT done by Intensivists

Within NA USA ~ 60% done by Nephrology but

often determined by manpower Adult Nephrologists = Adult Intensivists Pediatric Nephrologists < Pediatric Intensivists

Canada ~ 50% done by Nephrology

Who really does CRRT?

Nursing staff of the

Dialysis units- thank you Critical Care units- thank you Neonatal intensive Care units- thank

you

What is the purpose of this meeting?

To bring together those in the field who deal with any modality of MOSF with RRT who are willing to listen and learn, to talk and to exchange

There are no experts in this field!! “If you quit learning then it is time to go home”

(actually he said get the hell out before you hurt someone!)

Robert Vernier MD (U of Mn, retired)

Thank you To those of you who helped make this

meeting happen Faculty Carol Malone

Program and Meeting planner Stacey Hunt

Administer of my division who keeps me organized PCRRT Organizing committee PCRRT Foundation, Inc

Who are the faculty?

Jim Fortenberry MD Director of Pediatric Critical Care at

Eggleston Childrens Hospital in Atlanta, GA USA

Stefano Picca MD Pediatric Nephrologist @Bambino Gesu

Children’s research Hospital, Rome, Italy

Who are the faculty?

Helen Currier BSN, RN, CNN Clinical Program Specialist

Texas Children’s Hospital, Houston TX Stuart L Goldstein MD

Pediatric Nephrology @ Baylor College of Medicine & Texas Children’s Hospital, Houston TX

Who are the faculty?

Jordan Symons MD Pediatric Nephrology @ Univ of

Washington, Children’s Hospital of Seattle, Seattle, Wa

Patrick D Brophy MD FRCPC Associate Professor & Director Pediatric

Nephrologist University of Iowa, Iowa City, IA

Who are the faculty?

Prasad Devarajan MD Professor and Director Pediatric Nephrology

Cincinnati Children’s Hospital, Cincinnati, OH

Dawn Eding RN Pediatric Critical Care Nurse and

Coordinator of CRRT program, Helen DeVos Children’s Hospital, Grand Rapids, MI

Who are the faculty?

Maricor Grio MD Pediatric Nephrology Arnold Palmer

Children’s Hospital, Orlando, FL Rick Hackbarth MD

Pediatric Critical Care and Associate Professor Helen DeVos Children’s Hospital, Grand Rapids, MI

Who are the faculty?

Morgan R. Cole, Pharm.D., BCPS Manager, Helen DeVos Children's Hospital

Pharmacy Services, Grand Rapids, MI Michael Zappitelli MD, MSc

Assistant Professor Pediatric Nephrology Montreal Children’s Hospital & McGill University, Montreal Canada

What is in the bag?

CDR with all talks CDR also has an updated list of

references as well as heparin and citrate protocols

Pens and paper from Industry

Gambro ICU Medical MedComp Medigroup, Inc. NxStage

Covidien B. Braun Medical,

Inc. Dialysis Solutions,

Inc. Baxter Health Care Fresenius Medical,

Inc. Roche

Thanks to our Supporters

What is new this time?

Expansion of Workshops on Nursing by request Workshops by Industry by request Workshops on Drug monitoring by request Workshops on Nutrition by request

Session on Biomarkers Session on Infants and Neonates

Who are the Audience

21 abstracts were submitted from 9 separate countries

50% make up of Nursing 45% physician 5% pharmacist

A few requests

Ask questions.. we all learn

Interact with others outside your program during the breaks, lunch

Visit the booths learn what each machine, solution, and

access can do for your program

A few requests

Fill out your evaluation cards and hand them into the desk 14 CMEs 15 CEUs

Finally

Have fun and open your mind This is a therapy that is still in

development, the applications of these therapies are without boundaries

If Carol Malone, Stacey Hunt or I can help you in any way please do not hesitate to ask

Quote that I live by

“the smartest one in the room is the child”