[Therapy of conventionally uncontrollable hyperhydration with hemofiltration]

The authors report on three extracorporal methods for treating pulmonary hyperhydration which cannot be managed by drugs or respiratory measures. Of these three extracorporal treatment methods, mechanical haemofiltration (MHF) and pump-driven haemofiltration or ultrafiltration (PHF and PUF, respectively) require complicated equipment which can be operated only by personnel well-trained in extracorporal treatment methods. On the other hand, the third method can be handled even in intensive-care wards not equipped with dialysis facilities and which are not able to operate on a mechanical basis: This method is represented by the technique of continuous arteriovenous haemofiltration (CAVH), utilising relatively low doses of heparin so that the method can also be employed on freshly operated patients and accident victims. Although all treatment facilities are available in the authors' hospital, the CAVH method is employed in specific cases, since it places least stress on circulation provided accurate balance of fluid turnover thus achieved is secured.