[Continuous veno-venous haemofiltration in adult intensive therapy].
BACKGROUND
Continuous veno-venous haemofiltration (CVVH) has been recommended for renal replacement therapy in acute renal failure (ARF). The aim of the study was to analyse the usefulness of CVVH in intensive therapy settings.


METHODS
Sixteen adult patients, treated with CVVH because of ARF complicating multiple organ failure, were allocated to two groups: those who survived and those who did not. Serum lactate, creatinine, potassium, and C-reactive protein concentrations, together with WBC count and arterial blood gases, were assessed before the start of CVVH, and daily during the therapy. The severity of the patients' clinical state was rated according to the Sepsis-related Organ Failure Assessment scale (SOFA) at both the initiation and the termination of therapy.


RESULTS
The demographic data did not differ between the groups. Mean serum creatinine (171.5 vs 282.9 mmol L-1, p<0.05), blood lactate (1.8 vs 3.5 mmol L-1, p<0.05), and potassium concentrations (3.9 mmol L-1 vs 4.5 mmol L-1, p<0.05) were significantly higher in those patients who died. Mean SOFA scores were similar in both groups before the start of treatment, but were increased significantly at the end of therapy in the patients who died (7.0 vs 15.0, p<0.05). The concentrations of CRP, and WBC counts were similar in both groups.


CONCLUSIONS
We concluded that CVVH can be instituted in cases of ARF, regardless of age or condition of patients. Early institution of CVVH was effective and resulted in normalization of renal function and biochemical parameters.
Department of Anaesthesiology and Intensive Therapy, Medical University of Silesia in Katowice, Katowice-Ochojec. oait@gcm.pl
Grzegorz
G
Kluczewski
Danuta
D
Gierek
Adriana
A
Kaczmarska
Tomasz
T
Cyzowski
Józefa
J
Dąbek
Lukasz
L
Krzych
D000136:Acid-Base Equilibrium; D058186:Acute Kidney Injury / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006439:Hemodynamics; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000009:adverse effects; D012720:Severity of Illness Index
D015415:Biomarkers