Hemofiltration in a cardiac intensive care unit: time for a rational approach

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
G M TsangR L Patel

Abstract

The typical annual expenditure for patients requiring continuous hemofiltration (CHF) is high. To audit the benefit of this expensive treatment, the outcome of 48 consecutive patients (34 men, 14 women; mean age, 65 years) requiring hemofiltration for acute renal failure was analyzed during a period of 24 months. The operations performed were 26 CABG, 8 AVR, 3 AVR/MVR, 2 post infarction VSD repairs, and 1 thoracoabdominal aneurysmectomy. Indications for hemofiltration were oliguria and fluid overload in 69%, uremia in 56%, acidosis in 33%, and hyperkemia in 13%. Twenty five patients (52%) died while in the hospital, and 10 more died within 9 months of discharge. Of the remaining 13 survivors, 6 (46%) were classified as III or IV according to the New York Heart Association classification system. The mean ITU and hospital stay per patient requiring CHF was 15.3 days and 25.4 days, respectively. There were no statistically significant differences between patients who did and did not survive in the hospital in age, pre-operative renal function, ejection fraction, duration of cardiopulmonary bypass, or urine output before CHF. However, there were no survivors when the cardiac index was less than 1.7 L/m2 and adrenalin requirement wa...Continue Reading

Citations

Mar 28, 2001·The Annals of Thoracic Surgery·P BentB F Buxton
Jan 5, 2006·European Journal of Anaesthesiology·G LandoniG Marino
Mar 28, 2006·The Annals of Thoracic Surgery·Marzia LeaccheJohn G Byrne
Jul 31, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Stanislao MorgeraHans-H Neumayer

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