ISSN:
1432-1238
Keywords:
Continuous arteriovenous hemofiltration
;
Hemofiltration
;
Hemodialysis
;
Renal replacement therapy
;
Hemodynamic
;
Tolerance
;
Acute renal failure
;
Intensive care unit
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective To compare the hemodynamic response of ICU patients with acute renal failure of a 24-h continuous arteriovenous hemofiltration (CAVH) and that of patients with a 4-h intermittent hemodialysis (HD). Design Cross-over randomized clinical trial. The two periods to be compared were a 24-h CAVH and the 24-h encompassing a 4-h HD. These two periods were separated by a 24-h wash-out period. Setting Ten bed medicosurgical ICU of a tertiary care center in Paris, France. Patients Inclusion criterion was the requirement of replacement therapy for acute renal failure in patients already submitted to mechanical ventilation. Interventions CAVH was performed with Ringers' lactate used for restitution and infused before the hemofilter. The ultrafiltrate output was maintained at around 15 ml/min. HD was performed with a bicarbonate-buffered dialysate. Mean outcome measures Mean arterial pressure (MAP), use of adrenergic drugs, and change in body weight during each period. Results Twenty-seven consecutive patients were included, 15 CAVH-HD and 12HD-CAVH. CAVH and HD allowed the same metabolic efficacy. No hemodynamic parameter (MAP, amount of adrenergic drugs, change in body weight) differed between the two methods. Conclusions CAVH is equivalent to HD in terms of MAP and the use of vasopressive drugs and fluids. Establishing the superiority of CAVH would require carefully controlled studies assessing either outcome or changes in tissue oxygenation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01709515
