Continuous venovenous haemodialysis: a study of 84 cases

Slow continuous therapies are the choice treatment in critically ill patients with acute renal failure (ARF). Over 4 years (1994-97) we retrospectively studied 84 intensive-care unit patients suffering from ARF and multiple organ failure, and treated with continuous venonenous haemodialysis (CVV-HD). The main cause of ARF was sepsis (59.3%). The global mortality was 88% and the patients who died were older than the survivors (p = 0.004). The main cause of dialyser change was the ratio FUN/BUN < or = 0.8 (61.6%); this ratio was calculated from the quotient filtrate urea nitrogen/blood urea nitrogen (urea nitrogen = urea/2.14). Most patients (94.8%) treated with initial replacement fluid infusion didn't show falls in blood pressure (BP).

1. The mortality was higher in elderly patients. 2. In most cases the monitoring FUN/BUN ratio allowed recovery of the patient's blood before clotting in the extracorporeal circuit. 3. The replacement fluid infusion at the beginning of the CVV-HD procedure contributes to patient's haemodynamic stability, because BP usually falls due to excessive ultrafiltration.