[The efficiency of continuous hemofiltration/hemodialysis for acute respiratory failure complicated with acute renal...

Continuous hemofiltration/hemodialysis (CHF/CHD) have emerged as effective modalities in the management of acute renal failure. More recently, these therapies have received attention for non-renal application such as adult respiratory distress syndrome (ARDS) and multiple organ failure. To assess the potential benefits of CHF/CHD in the management of severe impairment of pulmonary gas exchange, we evaluated a series of clinical variables in a group of patients with acute respiratory failure complicated with acute renal failure. In 9 of 15 patients, pulmonary gas exchange was improved. Intrapulmonary shunt (Qs/Qt) and pulmonary vascular resistance were also improved during the therapies. The beneficial effects of the modalities seems to be induced by effective removal of extravascular lung water. However, the fact that the same effects were also observed in a few patients with zero or positive fluid balance may indicate the possibility of elimination of circulating middle-molecular pulmonary toxic mediators. We concluded CHF/CHD are recommendable methods for the management of acutely ill patients with respiratory failure.