Continuous arteriovenous haemofiltration and respiratory function in multiple organ systems failure.
OBJECTIVE
To determine what change in respiratory function occurred following prolonged and efficient continuous arteriovenous haemofiltration (CAVH) in a group of patients with multiple organ systems failure (MOSF).


METHODS
A retrospective assessment using patient notes and ICU charts.


METHODS
The Intensive Care Unit of a large University Teaching Hospital.


METHODS
All ICU patients satisfying the following criteria: (i) Failure of more than one organ system; (ii) Treatment with CAVH; (iii) Removal of more than 10 l of ultrafiltrate per day; (iv) Continuous haemofiltration for at least 5 days. Thirteen patients satisfied these criteria and 14 episodes of CAVH were analyzed.


METHODS
All data were recorded from the patient notes and ICU charts apart from the A-aDO2 and PaO2/FiO2 (PF) ratio which were calculated from available values. A mean of 3.5 different organ systems failed during the period of stay. The mean daily ultrafiltrate volume obtained was 23.7 (SD 0.95) l and the mean duration of treatment 9.6 (SD 4.3) days. Significant improvements occurred in the values for the PF ratio and ventilatory modality (p < 0.05), and the FiO2 and A-aDO2 (p = 0.001). The mean PEEP value remained unchanged at 4.8 cmH2O. Ten of the 13 patients subsequently died (77% mortality).


CONCLUSIONS
A significant improvement in respiratory function occurred in patients with MOSF who had undergone a prolonged period of intensive CAVH. Haemofiltration may therefore be a useful treatment for respiratory failure in this patient group. Unfortunately the overall mortality of the group remained high.
Bagshaw
O N
ON
Department of Anaesthesia, Queen's Medical Centre, University Hospital, Nottingham, UK.
Anaes
F R
FR
Hutchinson
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D004739:England / Q000453:epidemiology; D005260:Female; D006440:Hemofiltration / Q000379:methods / Q000592:standards*; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011175:Positive-Pressure Respiration / Q000379:methods; D012119:Respiration / Q000502:physiology*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome