Continuous Hemofiltration And Hemodialysis

Filter continuous Hämofiltration- and hemodialysis and dialyze the blood without interruption. The main advantage is the ability to remove large amounts of fluid while avoiding the arising in the course of intermittent hemodialysis hypotensive episodes and their intermittent removal of large amounts of liquid. Indicated these methods are however in patients with acute kidney injury, haemodynamically unstable patients who require large amounts of liquid (eg., Patients with multi-organ failure or shock, for example, need a hyperalimentation and / or a Vasopressortropf), or both.

(See also overview of the renal replacement therapy.) Filter Continuous Hämofiltration- and hemodialysis and dialyze the blood without interruption. The main advantage is the ability to remove large amounts of fluid while avoiding the arising in the course of intermittent hemodialysis hypotensive episodes and their intermittent removal of large amounts of liquid. Indicated these methods are however in patients with acute kidney injury, haemodynamically unstable patients who require large amounts of liquid (eg., Patients with multi-organ failure or shock, for example, need a hyperalimentation and / or a Vasopressortropf), or both. In the continuous hemofiltration and water-soluble substances with a molecular weight of up to 20,000 daltons are filtered by a permeable membrane from the blood by convection. The filtrate is discarded, and the patient is physiologically balanced infusions of water and electrolytes. A dialysis circuit can be added to the filter to improve the clearance of solutes. The methods can be venovenous In arteriovenous arteriovenous method, the femoral artery is cannulated and the arterial pressure forces the blood through the filter into the femoral vein. The filtration rates are usually low, especially in hypotensive patients. In continuous veno-venous method, a pump is required to (V. femoralis, subclavian, jugularis interna) blood from a large vein through the dialysis circuit and pump back into the venous circulation again. In use of a double catheter, the blood is pumped from a vein and returned into the same vein. The arteriovenous way has the advantage of a simple system without a pump is needed, but can result in patients with hypotension in unreliable blood flow. Advantages of venovenous route is a better control of blood pressure and a better filtration rate for a more gentle removal of liquid. Even the way venovenous cannulation requires only a vessel. None of the methods is superior to the other. Both methods require anticoagulation, most regional and not systemic. In regional citrate anticoagulation, the blood leaving the patient is infused with citrate, which binds calcium to prevent coagulation; Calcium is then reinfused when the blood returning from the machine to the patient. This method avoids the complications of systemic heparinization. However, not all patients get citrate (1). Note Acute Kidney Injury Workgroup. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl2 (1): 89-115, 2012 Design.

Health Life Media Team

Leave a Reply