Temporary Veno-venous Hemofiltration (TVVH) Using Low Flux Hemodialyzers.
- Author:
Yoon Jeong LEE
1
;
Sung Hee JOHN
;
Gum Mo JUNG
;
Hyun Jong CHOI
;
Jong Pil PARK
;
Jung Hwa KIM
;
Kwang Young LEE
Author Information
1. Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea. kwangyou@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Continuous veno-venous hemofiltration (CVVH);
Temporary veno-venous hemofiltration (TVVH);
High flux hemofilters;
Low flux hemodialyzers
- MeSH:
Cost-Benefit Analysis;
Edema;
Hemofiltration*;
Humans;
Kidney Failure, Chronic;
Kidneys, Artificial*;
Membranes;
Positive-Pressure Respiration;
Pulmonary Edema;
Renal Dialysis;
Renal Insufficiency;
Renal Replacement Therapy;
Respiration, Artificial;
Ultrafiltration;
Vital Signs;
Water Purification
- From:Korean Journal of Nephrology
2003;22(6):706-712
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Continuous veno-venous hemofiltration (CVVH) is one of the continuous renal replacement therapies for managing patients with refractory edema or oliguric renal failure with unstable vital signs. High-flux hemofilters are usually used for CVVH, but low-flux hemodialyzers are not used for CVVH. We tried temporary veno-venous hemofiltration (TVVH) procedures using low-flux hemodialyzers for 9 patients with acute or chronic renal failure who were on mechanical ventilation with positive end-expiratory pressure (PEEP) in the ICU. METHODS: All of the nine patients with acute or chronic oligo-anuric renal failure could not receive hemodialysis treatment in the hemodialysis room, because they were on mechanical ventilation with PEEP in the ICU due to severe fluid overload with elevated CVP and acute pulmonary edema. Low-flux hemodialyzers with effective membrane area of 1.0- 1.1 m2 and blood pumps on the discarded hemodialysis machines were used for TVVH procedures. RESULTS: Mean duration of TVVH was 17.0+/-16.7 hours and mean ultrafiltration rate was 440+/-203 mL/hour. After finishing the TVVH procedures, CVP decreased from 22.9+/-8.5 cmH2O to 6.4+/-2.4 cmH2O. Of nine patients, 6 patients (67%) were able to be off the mechanical ventilation with clinical improvement. CONCLUSION: Even if CVVH is usually done with expensive high-flux hemofilters and CVVH machines, simplified and cheaper TVVH procedures using low- flux hemodialyzers and discarded hemodialysis machines with functioning blood pumps can be done with good results and cost effectiveness, especially in institutions not equipped with facilities such as CVVH machines or portable water purification systems for hemodialysis in the ICU.
