Continuous Venovenous Haemodiafiltration - Essay Example

that permits filtration of solutes in the blood by diffusion across the semipermeable membrane, the dialyzer, and by convection of solutes across the membrane as they are separated or filtrated from the whole blood in response to hydrostatic pressure (Bellomo, R., 1996). In contrast to intermittent haemodialysis, CVVHD employs slow continuous ultrafiltration that utilizes high-efficiency dialyzers with low blood and dialysate flow rates. In the acute care setting, the patients with acute renal failure are often unstable, and CVVHD is often preferable to haemodialysis.

Furthermore, the classical intermittent haemodialysis has its limitations in haemodynamically unstable patients (Davenport, A., 1993). In fact, CVVHD has shown to improve haemodynamic and cerebrovascular stability in acute renal failure in the setting of multiorgan failure like liver failure or cerebral edema (Davenport, A., 1995). With CVVHD, sophisticated pump-driven devices that have venovenous access are used. Since this blood is circulated through the dialysis haemofilter, inherent risks of arterial route is obviated.

Apart from organ failure, the other indications for use of venovenous haemodiafiltrate are acute renal failure complicated by refractory fluid overload, haemodynamic instability, and major life-threatening electrolyte imbalance and instability causing acid-base imbalance (Kirschbaum, B et al, 1992). Relevance in Critical Care: Trauma, burns, and pancreatitis are there major critical care admissions. These are known for release of many inflammatory materials in the body in response to the original insult.

This constitutes the SIRS or systemic inflammatory response syndrome. Another. Anaesth Intensive Care. 1996 Aug;24(4):423-9. PMID: 8862637 [PubMed - indexed for MEDLINE] Leslie GD, Jacobs IG, Clarke GM, Proximally delivered dilute heparin does not improve circuit life in continuous venovenous haemodiafiltration. Intensive Care Med. 1996 Nov;22(11):1261-4. PMID: 9120123 [PubMed - indexed for MEDLINE] Wetering J van de, Westendorp RG, van der Hoeven JG, Stolk B, Feuth JD, Chang PC, Heparin Use In Continuous Renal Replacement Procedures: The Struggle Between Filter Coagulation And Patient Hemorrhage.

J Am Soc Nephrol. 1996 Jan;7(1):145-50. PMID: 8808122 [PubMed - indexed for MEDLINE]