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Related Concept Videos

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...

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Related Experiment Videos

High-volume haemofiltration for sepsis.

Emma M J Borthwick1, Christopher J Hill, Kannaiyan S Rabindranath

  • 1Regional Nephrology Unit, Belfast City Hospital, Belfast, UK.

The Cochrane Database of Systematic Reviews
|February 27, 2013
PubMed
Summary
This summary is machine-generated.

High-volume haemofiltration (HVHF) shows no adverse effects in critically ill sepsis patients. However, insufficient evidence exists to recommend HVHF, necessitating large clinical trials to assess its efficacy and financial implications.

Related Experiment Videos

Area of Science:

  • Critical care medicine
  • Nephrology
  • Sepsis management

Background:

  • Severe sepsis and septic shock are leading causes of death in ICUs despite advances in care.
  • High-volume haemofiltration (HVHF) is a blood purification technique that evolved from renal replacement therapies.
  • HVHF is being investigated for its potential to improve outcomes in critically ill patients with sepsis.

Purpose of the Study:

  • To assess whether HVHF improves clinical outcomes in adult critically ill patients with sepsis in an ICU setting.

Main Methods:

  • A systematic review of randomized controlled trials (RCTs) and quasi-RCTs was conducted.
  • Studies compared HVHF or high-volume haemodiafiltration to standard dialysis or no dialysis therapy in adult critical care units.
  • Data extraction and quality assessment were performed independently by three reviewers.

Main Results:

  • Three RCTs involving 64 participants were included.
  • Due to small sample sizes, data pooling and subgroup analyses were not possible.
  • No adverse events were reported; however, evidence on mortality and length of stay was limited and inconsistent.

Conclusions:

  • There is insufficient evidence to recommend HVHF for critically ill sepsis patients outside of clinical trials.
  • Future large, multi-centered RCTs are needed to evaluate HVHF's clinical effectiveness and cost-effectiveness.
  • No adverse effects of HVHF were reported in the included studies.