Continuous hemofiltration in 2009: what is new for clinicians regarding pathophysiology, preferred technique and recommended dose?

Abstract:

:In the last years, publications have questioned the classical dose of 35 ml/kg, but are those studies strong enough in terms of scientific power in order to change our practice? We will try to settle some recommendations for clinicians. Manipulation of dose, porosity, and combinations have yielded promising findings. However, conclusive evidence based on randomized trials remains scarce, limiting the practical implementation in daily practice. From the few designed studies, it is safe to say that optimization of delivered dose has a proven positive effect. An ultrafiltration rate of around 35 ml/kg/h, with adjustment for predilution, can be recommended for the septic patient. Recent studies do not have enough power to change this recommendation in view of its shortcomings. Finally the recommendation is to keep going with a continuous technique, a pure continuous veno-venous hemofiltration mode, and at a dose of 35 ml/kg/h while waiting for other studies to be published.

journal_name

Blood Purif

journal_title

Blood purification

authors

Honoré PM,Joannes-Boyau O,Collin V,Boer W,Jennes S

doi

10.1159/000227282

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

135-43

issue

2

eissn

0253-5068

issn

1421-9735

pii

000227282

journal_volume

28

pub_type

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