CAVH in continuous renal replacement therapy is often regarded as one of most important advances in intensive care medicine in recent years. CAVH has been used widely for patients with acute renal failure combined with cardiovascular instability, severe fluid overload, cerebral edema or hyper catabolism, systemic inflammatory response syndrome and sepsis, acute respiratory distress and cardiopulmonary bypass. The continuous renal replacement therapy has to be started early to prevent multi-organ dysfunction.
Hemofiltration ; Renal Replacement Therapy

No abstract available.
Critical Illness* ; Hemofiltration* ; Humans

No abstract available.
Child* ; Hemofiltration* ; Humans

No abstract available.
Child* ; Hemofiltration* ; Humans

PURPOSE: We tried to estimate the clinical efficacy of hemodiafiltration in the paraquat poisoning, as compared with that of other various extracorporeal extraction treatment. METHODS: We prepared the fresh frozen plasma mixed with paraquat concentrated up to 30 mg/L. The experiment was designed to remove paraquat by use of various extracorporeal treatment, such as hemodialysis (HD), hemoperfusion (HP), hemofiltration (HF), hemodia-filtration (HDF), hemodiafiltration & hemoperfusion (HDFP), respectively. The efficacy was analyzed on the basis of counting extraction ratio, observing the decreasing concentration of paraquat with the lapse of time. Four pigs (Yorkshire) were prepared and poisoned by paraquat (40 mg/kg) intramuscularly. Two poisoned animals were assigned for hemoperfusion and hemodiafiltration respectively and other two were assigned for the control. We observed extraction ratio, decreasing concentration of paraquat in blood, remained amount of paraquat in major organs, in addition to pathologic change of major organs after sacrifying the animals. RESULTS: The mean of extraction ratio is 0.84+/-0.27 in case of HP, 0.81+/-0.21 in HD, 0.74+/-0.40 in HDFP, 0.53+/-0.24 in HDF, 0.5+/-0.14 in HF. The extraction ratio of HP & HD & HDFP was significantly higher than that of HDF & HF (p<0.01). The extraction ratio was counted as the difference between the paraquat concentration of inlet and outlet was divided by the concentration of inlet. The slope of paraquat concentration undergoing extracorporeal treatment was the most acutely decreased in the case of HDFP, the less decreased in HP, and sequentially in HD, HDF and HF (the least) in the order of the decrease. The more decreased paraquat concentration in plasma was observed, the higher flow rate of dialysate of HDF was conducted. The mean of extraction ratio in animal study was 0.61 in HP and 0.36 in HDF. The blood concentration of paraquat was observed to be much lower in case of HP & HDF, as compared with the control animals. The remained concentration of paraquat in major organs, 7 hours later after being poisoned, was observed to be higher in the vascular structure like kidney and heart. However, it was observed to be lower in kidney, lung & muscle, when either of HDF and HP was conducted, than control. Especially, it was much lower in HP and much less pathologic change in HP. HDF is the less effective measure than HP, but is effective as a continuous treatment to make paraquat concentration to be lower as much as it possible. CONCLUSION: The HDF is the effective measure to keep the blood paraquat level low, even though it is behind the HP in effectiveness.
Animals ; Bays ; Heart ; Hemodiafiltration* ; Hemofiltration ; Hemoperfusion ; Kidney ; Lung ; Paraquat* ; Plasma ; Poisoning ; Renal Dialysis ; Swine

PURPOSE: We tried to estimate the clinical efficacy of hemodiafiltration in the paraquat poisoning, as compared with that of other various extracorporeal extraction treatment. METHODS: We prepared the fresh frozen plasma mixed with paraquat concentrated up to 30 mg/L. The experiment was designed to remove paraquat by use of various extracorporeal treatment, such as hemodialysis (HD), hemoperfusion (HP), hemofiltration (HF), hemodia-filtration (HDF), hemodiafiltration & hemoperfusion (HDFP), respectively. The efficacy was analyzed on the basis of counting extraction ratio, observing the decreasing concentration of paraquat with the lapse of time. Four pigs (Yorkshire) were prepared and poisoned by paraquat (40 mg/kg) intramuscularly. Two poisoned animals were assigned for hemoperfusion and hemodiafiltration respectively and other two were assigned for the control. We observed extraction ratio, decreasing concentration of paraquat in blood, remained amount of paraquat in major organs, in addition to pathologic change of major organs after sacrifying the animals. RESULTS: The mean of extraction ratio is 0.84+/-0.27 in case of HP, 0.81+/-0.21 in HD, 0.74+/-0.40 in HDFP, 0.53+/-0.24 in HDF, 0.5+/-0.14 in HF. The extraction ratio of HP & HD & HDFP was significantly higher than that of HDF & HF (p<0.01). The extraction ratio was counted as the difference between the paraquat concentration of inlet and outlet was divided by the concentration of inlet. The slope of paraquat concentration undergoing extracorporeal treatment was the most acutely decreased in the case of HDFP, the less decreased in HP, and sequentially in HD, HDF and HF (the least) in the order of the decrease. The more decreased paraquat concentration in plasma was observed, the higher flow rate of dialysate of HDF was conducted. The mean of extraction ratio in animal study was 0.61 in HP and 0.36 in HDF. The blood concentration of paraquat was observed to be much lower in case of HP & HDF, as compared with the control animals. The remained concentration of paraquat in major organs, 7 hours later after being poisoned, was observed to be higher in the vascular structure like kidney and heart. However, it was observed to be lower in kidney, lung & muscle, when either of HDF and HP was conducted, than control. Especially, it was much lower in HP and much less pathologic change in HP. HDF is the less effective measure than HP, but is effective as a continuous treatment to make paraquat concentration to be lower as much as it possible. CONCLUSION: The HDF is the effective measure to keep the blood paraquat level low, even though it is behind the HP in effectiveness.
Animals ; Bays ; Heart ; Hemodiafiltration* ; Hemofiltration ; Hemoperfusion ; Kidney ; Lung ; Paraquat* ; Plasma ; Poisoning ; Renal Dialysis ; Swine

With the widespread availability of dialysis, the lives of end-stage renal disease patients have been prolonged over the past fifty years. Hemodialysis relies on the diffusion of molecules across a semipermeable membrane along the concentration gradient. In addition to diffusion, movement of waste products from the circulation into the dialysate can occur as a result of convective clearance. Use of high-flux dialyzer has increased the removal of the middle molecules such as beta2-microglobulin. Recently on-line hemodiafiltration which combined the hemodialysis and hemofiltration to increase the convective clearance of the large molecules has been available. About the hemodialysis adequacy, the result of hemodialysis (HEMO) study suggests that increasing the dose to greater than a single-pool Kt/Vurea 1.4 does not improve the survival of the patients. While the technical and scientific improvement in hemodialysis has led to a noticeable improvement in the survival of the dialysis patients, cardiovascular mortality and event rates are extraordinarily high in dialysis population. In addition to hemodialysis treatment, nephrologists taking care of dialysis patients must recognize and treat the diverse complications that can result from the loss of kidney function.
Dialysis ; Diffusion ; Hemodiafiltration ; Hemofiltration ; Humans ; Kidney ; Kidney Failure, Chronic ; Membranes ; Mortality ; Renal Dialysis* ; Waste Products

With the widespread availability of dialysis, the lives of end-stage renal disease patients have been prolonged over the past fifty years. Hemodialysis relies on the diffusion of molecules across a semipermeable membrane along the concentration gradient. In addition to diffusion, movement of waste products from the circulation into the dialysate can occur as a result of convective clearance. Use of high-flux dialyzer has increased the removal of the middle molecules such as beta2-microglobulin. Recently on-line hemodiafiltration which combined the hemodialysis and hemofiltration to increase the convective clearance of the large molecules has been available. About the hemodialysis adequacy, the result of hemodialysis (HEMO) study suggests that increasing the dose to greater than a single-pool Kt/Vurea 1.4 does not improve the survival of the patients. While the technical and scientific improvement in hemodialysis has led to a noticeable improvement in the survival of the dialysis patients, cardiovascular mortality and event rates are extraordinarily high in dialysis population. In addition to hemodialysis treatment, nephrologists taking care of dialysis patients must recognize and treat the diverse complications that can result from the loss of kidney function.
Dialysis ; Diffusion ; Hemodiafiltration ; Hemofiltration ; Humans ; Kidney ; Kidney Failure, Chronic ; Membranes ; Mortality ; Renal Dialysis* ; Waste Products

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*