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Continuous venovenous hemodialysis

B L Strohschein1, D M Caruso, K A Greene

  • 1Department of Surgery, Maricopa Medical Center, Phoenix, AZ 85008.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|March 1, 1994
PubMed
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Continuous venovenous hemodialysis offers a safer alternative for critically ill patients with acute renal failure, especially those with neurological conditions like cerebellar hemorrhage, mitigating risks associated with conventional dialysis.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Neurology

Background:

  • Acute renal failure (ARF) in critically ill patients presents treatment challenges.
  • Conventional dialysis therapies (hemodialysis, peritoneal dialysis) can cause complications like fluid shifts and hemodynamic instability.
  • Continuous hemodialysis (CHD) is emerging as a preferred treatment for critically ill patients due to its gentler approach.

Observation:

  • A patient with spontaneous cerebellar hemorrhage developed acute renal failure.
  • Surgical intervention was contraindicated.
  • Continuous venovenous hemodialysis (CVVH) was implemented for renal replacement therapy.

Findings:

  • CVVH provided renal support without exacerbating the patient's neurological condition or causing hemodynamic instability.

Related Experiment Videos

  • The case highlights the successful application of CVVH in a complex neurocritical care setting.
  • Potential complications such as anticoagulation issues, hemodynamic compromise, and dialysis disequilibrium syndrome were considered and managed.

    • Implications:

    • Continuous venovenous hemodialysis is a viable and potentially safer option for acute renal failure management in neurocritical care patients.
    • This approach may reduce the risks associated with conventional dialysis in hemodynamically unstable or neurologically compromised patients.
    • Further research into CVVH protocols for specific critical care populations is warranted.