[Continuous arteriovenous hemofiltration in acute renal failure. Value of regulating the rate of ultrafiltration].
Continuous arteriovenous hemofiltration (CAVH) requires constant supervision and frequent readjustment of the rate of infusion of the substitution fluid because of variable filtration rate. In order to lighten the management of patients treated with CAVH, an ultrafiltration-pump assisted CAVH was used in 16 patients with oliguric renal failure and cardiovascular instability treated in the intensive care unit. A plate hemofilter (Biospal) was used which is equipped with the high hydraulic permeability AN 69 S membrane. The driving pump was set in order to modulate the ultrafiltration rate from 400 to 1000 ml/h. Ultrafiltration-pump assisted CAVH was given for 8.1 +/- 5.3 days and the filtration volume was 16.3 +/- 3.1 l/day. The mean life span of the hemofilter was 36.4 +/- 27.3 hours. No adverse reaction toward the artificial membrane was detected. Adequate control of fluid balance and electrolyte and acid-base homeostasis were obtained allowing parenteral nutrition. However, in two instances additional hemodialysis was required to adequately control urea generation. Ultrafiltration-pump assisted CAVH proved to be a simple and effective method of fluid removal and urea subtraction by convective transport. Maintenance of stable fluid balance and parenteral nutrition without osmotic disequilibrium was allowed. The pump driven hemofiltration allows optimal use of the filter.
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D001769:Blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014462:Ultrafiltration / Q000295:instrumentation / Q000379:methods*
Hémofiltration artérioveineuse continue dans l'insuffisance rénale aiguë Intérêt de la régulation du débit d'ultrafiltration.