Continuous venovenous haemodialysis: a study of 84 cases.
Slow continuous therapies are the choice treatment in critically ill patients with acute renal failure (ARF). Over 4 years (1994-97) we retrospectively studied 84 intensive-care unit patients suffering from ARF and multiple organ failure, and treated with continuous venonenous haemodialysis (CVV-HD). The main cause of ARF was sepsis (59.3%). The global mortality was 88% and the patients who died were older than the survivors (p = 0.004). The main cause of dialyser change was the ratio FUN/BUN < or = 0.8 (61.6%); this ratio was calculated from the quotient filtrate urea nitrogen/blood urea nitrogen (urea nitrogen = urea/2.14). Most patients (94.8%) treated with initial replacement fluid infusion didn't show falls in blood pressure (BP).


CONCLUSIONS
1. The mortality was higher in elderly patients. 2. In most cases the monitoring FUN/BUN ratio allowed recovery of the patient's blood before clotting in the extracorporeal circuit. 3. The replacement fluid infusion at the beginning of the CVV-HD procedure contributes to patient's haemodynamic stability, because BP usually falls due to excessive ultrafiltration.
Ureña Galipienzo
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Department of Nephrology, Hospital Vall d'Hebron, Barcelona, Spain.
D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome