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Automatic continuous venovenous hemodiafiltration in cardiosurgical patients
R Caprioli1, G Favilla, D Palmarini
1Division of Nephrology, Spedali Riuniti di Santa Chiara, Pisa, Italy.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 1993
Summary
Continuous venovenous hemodiafiltration effectively treats acute renal failure in critically ill patients. This method ensures stable fluid balance and waste product removal, overcoming challenges of intermittent treatments.
Area of Science:
- Nephrology
- Intensive Care Medicine
Background:
- Intermittent renal replacement therapies pose challenges for hemodynamically unstable, critically ill patients with acute renal failure.
- Continuous venovenous hemodiafiltration (CVVHDF) offers a potential solution by combining diffusive and convective solute transport for gradual waste and fluid removal.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous venovenous hemodiafiltration using the Equaline System in patients with acute renal failure post-cardiovascular surgery and cardiogenic shock.
Main Methods:
- Eight patients with acute renal failure received CVVHDF treatment utilizing an Equaline System with double lumen venous catheters.
- A polysulfone filter (0.4 m2) was employed with a blood flow of 30 ml/min and dialysate flow rate of 16.6 ml/min.
- Sterile, pyrogen-free hemofiltration substitution fluid served as the dialysate for the mean treatment duration of 10.3 days.
Main Results:
- Significant reductions in blood urea nitrogen (BUN) and creatinine levels were observed within 72 hours.
- Mean BUN decreased from 136 to 53.5 mg/dl, and mean creatinine dropped from 6.9 to 2.6 mg/dl.
- A controlled steady-state was achieved with a mean urea clearance of 21 ml/min and a mean ultrafiltration rate of 20.3 L/day.
Conclusions:
- Continuous venovenous hemodiafiltration, particularly with the Equaline System, is effective for managing acute renal failure in critically ill patients.
- This technique facilitates efficient waste product clearance and precise fluid balance management in catabolic patients with multiple organ failure.