title: A prospective comparative study of continuous arteriovenous hemodiafiltration and continuous venovenous hemodiafiltration in critically ill patients.
abstract: We have prospectively studied and compared two consecutive groups of critically ill patients treated with either continuous arteriovenous hemodiafiltration (CAVHD) (n = 28) or continuous venovenous hemodiafiltration (CVVHD) (n = 25) to establish the technique of choice. The two groups were comparable in mean age (59 v 58 years), mean Acute Physiology and Chronic Health Evaluation (APACHE) II score (29.6 v 27.4, P = NS), requirements for inotropic drugs, and mean number of failing organs (2.9 v 3.2). CVVHD led to a greater amount of hourly ultrafiltrate (mean, 590 v 424 mL; P < 0.001), but urea and creatinine clearances were not significantly different with the two techniques. Twelve patients survived in the CAVHD group (42.8%) and 13 in the CVVHD group (52%; P = NS). The major advantage for CVVHD use was the substantial decrease in the number of access-related complications (2 v 10; P < 0.025). We conclude that while CVVHD does not offer a significant increase in solute clearance, it significantly minimizes vascular access-related morbidity and should therefore be regarded as the therapeutic modality of choice.
authors: Monash Medical Centre, Clayton, Victoria, Australia.
authors: R
authors: R
authors: Bellomo
authors: G
authors: G
authors: Parkin
authors: J
authors: J
authors: Love
authors: N
authors: N
authors: Boyce
mesh_terms: D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D014508:Urea / Q000097:blood
chemical_list: D014508:Urea; D003404:Creatinine