The technique of slow continuous ultrafiltration. Steps to maintain fluid balance without hemodynamic instability

Slow continuous ultrafiltration (SCUF) is ideally suited for fluid overloaded patients with renal insufficiency, and for patients who need intravenous fluids in amounts that exceed renal excretory capacity. Like other methods of continuous ultrafiltration, including CAVH and CAVHD, SCUF can be performed in the intensive care unit with a minimum of equipment. During SCUF, arterial blood (usually from the femoral artery) is passed through a hollow-fiber hemofilter; an ultrafiltrate of serum collects at a rate that is determined by the patient's blood pressure. Replacement of intravenous fluids is generally not required with SCUF. The amount of ultrafiltrate that is removed can be titrated to achieve the desired fluid balance.