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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...
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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...
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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Prolonged intermittent high-volume hemofiltration in severe septic shock.

Rodrigo A Sepúlveda1,2, Cristián Juanet1,2, Juan P Huidobro1,2

  • 1Department of Nephrology, School of Medicine, Pontificia Universidad Católica de Chile, Red de Salud UC-Christus, Santiago, Chile.

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|February 25, 2026
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Summary

Prolonged intermittent high-volume hemofiltration (HVHF) may help manage severe septic shock. This therapy showed potential benefits, particularly for women and surgical patients, by supporting hemodynamics and modulating the immune system.

Keywords:
Hemofiltrationacute kidney injuryprolonged intermittent renal replacement therapyseptic shock

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Intensive Care

Background:

  • Septic shock is a life-threatening condition requiring advanced interventions.
  • High-volume hemofiltration (HVHF) is explored for hemodynamic support and immunomodulation in severe septic shock.

Purpose of the Study:

  • To evaluate the response to HVHF in severe septic shock patients.
  • To identify factors associated with mortality in this patient cohort.

Main Methods:

  • Retrospective cohort study of 63 severe septic shock patients receiving HVHF.
  • Analysis of patient demographics, clinical data, and outcomes.

Main Results:

  • Mortality was associated with male sex, medical pathology, chronic critical illness, elevated SOFA scores, and high norepinephrine doses.
  • HVHF within 24 hours of surgery correlated with lower mortality (p=0.025).
  • Actual mortality (73%) was lower than predicted by SOFA scores (80%-90%).

Conclusions:

  • HVHF may facilitate management of severe septic shock, especially in women and surgical patients.
  • The therapy offers hemodynamic support and immunomodulation, potentially improving prognosis.
  • HVHF allows time for infection control and better patient outcomes.