Treatment of acute renal failure in an infant using continuous arteriovenous hemofiltration

Lieberman, Kenneth V.; Nardi, Lorraine; Bosch, Juan P.

doi:10.1016/s0022-3476(85)80095-0

Cited by 35 publications

(4 citation statements)

References 7 publications

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“…CAVH has been proved to be a safe and simple method for term and preterm neonates with acute renal failure [1][2][3][4][5][6][7][8][9][10][11], Yet, CAVH may fail to control azotemia when a hypercatabolic state overcomes urea clearance. Prof Continuous arteriovenous hémodiafiltra tion (CAVHD) is another approach, combin ing a diffusive process with a convective transport.…”

mentioning

confidence: 99%

Urea Removal by Hemofiltration and Hemodiafiltration

Gouyon¹,

Petion²,

Huet³

et al. 1994

Neonatology

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Continuous hemofiltration is usually regarded as a safe method for controlling fluid overload in neonates presenting acute renal failure. We considered that continuous hemodiafiltration with a hemofilter type especially designed for use in the neonatal period could improve urea removal as compared with hemofiltration. Continuous arteriovenous hemofiltration (CAVH) and hemodiafiltration (CAVHD) were consecutively performed on 7 anesthetized adult rabbits which were given an urea infusion. The hemofilter was a 800-cm² polysulfone model (Amicon Minifilter Plus). Mean values for physiological and operational parameters were comparable during CAVH and CAVHD, i.e., mean blood pressure (69.6 ± 14.9 and 70 ± 13.1 mm Hg, respectively), arterial oncotic pressure (16.0 ± 2.4 and 16.0 ± 1.7 mm Hg), hematocrit (36.2 ± 5.8 and 36.7 ± 4.4%), protein plasma level (38.9 ± 7.0 and 39.0 ± 6.4 g/l), urea plasma level (20.6 ± 6.5 and 19.9 ± 7.0 mmol/l), plasma flow in the hemofilter (7.89 ± 8.48 and 7.12 ± 3.08 ml/min), and ultrafiltrate rate (1.17 ± 0.49 and 1.73 ± 0.78 ml/min). CAVHD allowed a significant increase in urea clearance (4.74 ± 4.51 ml/min) as compared with CAVH (1.23 ± 0.81 ml/min). These experimental results suggest that CAVHD usefulness should be assessed in neonates presenting acute renal failure.

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mentioning

confidence: 99%

Urea Removal by Hemofiltration and Hemodiafiltration

Gouyon¹,

Petion²,

Huet³

et al. 1994

Neonatology

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“…hämodynamische Auswirkungen [10,29,31]. Die vielfach angeführt theoretische Gefahr eines Dysäquilibriums [18,29] ist wegen der vernachlässigbaren Funktion des Ammoniaks für die Plasmaosmolalität nicht gegeben [33]. Die vielfach angeführt theoretische Gefahr eines Dysäquilibriums [18,29] ist wegen der vernachlässigbaren Funktion des Ammoniaks für die Plasmaosmolalität nicht gegeben [33].…”

Section: Diskussionunclassified

“…In der Behandlung von Hyperammonämien und anderen metabolischen Störungen werden die Verfahren deshalb trotz einer im Vergleich zu der Hämodialyse niedrigeren Clearance für niedrigmolare wasserlösliche Substanzen wie Ammoniak empfohlen [17,35] und erfolgreich bei Kindern angewandt [8,18,22,29,31]. Sonderformen sind die blutdruckgesteuerte kontinuierliche arteriovenöse Hämofiltration und die von extern pumpengesteuerte koninuierliche venovenöse Hämofiltration.…”

Section: Diskussionunclassified

Behandlung des hyperammonämischen Komas bei Neugeborenen und Säuglingen durch Hämodialyse oder Hämofiltration

Ermisch

Hildebrandt

Zimmerhackl

et al. 1997

Monatsschrift Kinderheilkunde

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“…However, the small filter sizes and low filter blood flows (QB) associated with pediatric circuits might combine to produce functional characteristics that differ significantly from adult circuits. Although several pediatric case descriptions have been published [1,[8][9][10], to our knowledge the operating characteristics of various CAVH circuit designs have not been systematically studied in a pediatricsized animal model.…”

Section: Introductionmentioning

confidence: 99%

Operating characteristics of pediatric continuous arteriovenous hemofiltration in an animal model

1993

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Continuous arteriovenous hemofiltration (CAVH) is an increasingly popular technique in the care of critically ill children. The operating characteristics of the available circuits are largely unknown. Prior to introducing CAVH into our pediatric intensive care unit, we investigated the performance of three CAVH circuits: CAVH with postfilter dilution, CAVH with prefilter dilution (CAVHpre) and CAVH with dialysis counterflow. Using a neonatal lamb model, we measured filter blood flow (QB), ultrafiltrate rate (QU), arterial, venous and ultrafiltrate compartment pressures, oncotic pressure, plus urea levels in blood and ultrafiltrate fluid for the three CAVH circuit designs. Transmembrane pressure and urea clearance were calculated for various values of QB after varying a clamp on the arterial side of the circuit. The major finding, applicable to all circuits, was the wide variability of QB. Constant attention was required in order to obtain a consistent QB. Fluid clearance was effective with all three circuits. Urea clearance averaged 5-10 ml/min and was principally dependent on QU and independent of QB. The addition of dialysis counterflow did not increase urea clearance. The most convenient circuit we tested was CAVHpre, but the problem of unstable QB is common to all unpumped arteriovenous filtrate circuits. It is a major limiting factor in the practical application of this technology to critically ill children.

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Treatment of acute renal failure in an infant using continuous arteriovenous hemofiltration

Cited by 35 publications

References 7 publications

Urea Removal by Hemofiltration and Hemodiafiltration

Urea Removal by Hemofiltration and Hemodiafiltration

Behandlung des hyperammonämischen Komas bei Neugeborenen und Säuglingen durch Hämodialyse oder Hämofiltration

Operating characteristics of pediatric continuous arteriovenous hemofiltration in an animal model

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