Continuous arteriovenous hemofiltration. A report of six months' experience

Continuous arteriovenous hemofiltration using small hollow-fiber hemofilters, without pumps, was used as an alternative to conventional methods of acute dialytic therapy. During a 6-month period, 15 patients had 17 treatments. Mean treatment duration was 98.5 +/- 101.1 (SD) hours (range, 4 to 300 hours), for a total of 1673 hours. Mean output per treatment was 9.5 +/- 4.4 mL/min, which was found to be adequate to control uremia despite a considerable protein intake. Six patients had a significant hemorrhage; however, all 6 had active bleeding and existing coagulopathies before beginning treatment. Overall, continuous arteriovenous hemofiltration was found to be a convenient and safe method for providing continuous fluid, electrolyte, and acid-base balance in patients with inadequate renal function. The treatment was particularly useful in patients with vascular instability or severe fluid overload.