title: Acid-base responses to high-volume haemofiltration in the critically ill.
abstract: We have studied the acid-base and cardiorespiratory effects of intermittent pumped high-volume venovenous haemofiltration (HVHF) using replacement fluid containing lactate as the source of bicarbonate in critically ill patients. We demonstrated significant hyperlactataemia throughout the procedure, but there was no deterioration in acid-base status, haemodynamics, or oxygen delivery. These observations suggest that the worsening of acidosis and the hypotension that have been described with this technique can be avoided by appropriate monitoring and resuscitation prior to haemofiltration, and may be due to unrecognized inadequacies in the oxygen transport system.
authors.affiliation: Intensive Therapy Unit, Western General Hospital, Edinburgh, UK.
authors.forename: G R
authors.initials: GR
authors.lastname: Nimmo
authors.forename: S J
authors.initials: SJ
authors.lastname: Mackenzie
authors.forename: S
authors.initials: S
authors.lastname: Walker
authors.forename: M
authors.initials: M
authors.lastname: Nicol
authors.forename: I S
authors.initials: IS
authors.lastname: Grant
mesh_terms: D000137:Acid-Base Imbalance / Q000209:etiology*; D058186:Acute Kidney Injury / Q000378:metabolism / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D006440:Hemofiltration / Q000009:adverse effects*; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007773:Lactates / Q000008:administration & dosage / Q000097:blood; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000628:therapy
chemical_list: D007773:Lactates; D019344:Lactic Acid