To test the ability of a novel super high-flux (SHF) membrane with larger pore size to clear myoglobin from serum.The intensive care unit university teaching hospital.A patient serotonin syndrome complicated by severe rhabodomyolysis and oliguric acute renal failure.Initially continuous veno-venous hemofiltration was performed at 2 l/hour ultrafiltration (UF) standard polysulphone 1.4 m2 (cutoff point, 20 kDa), followed SHF 100 kDa) UF, then 3 UF 4 in an attempt myoglobin.The concentration...

To determine the impact of replacement fluid infusion site on filter life and azotemic control during continuous veno-venous hemofiltration (CVVH).Pre-dilution CVVH was conducted from February 2001 to December then practice changed post-dilution (from January 2002 July 2002). Filter prospectively observed following data obtained for each filter: starting date time, ending heparin use, dose protamine use. Daily creatinine, urea, INR, APTT platelet count were also collected.Forty-eight...

Despite studies demonstrating benefit, patients with femoral vascular catheters placed for continuous renal replacement therapy are frequently restricted from mobilization. No researchers have reported filter pressures during mobilization, and it is unknown whether mobilization safe or affects lifespan. Our objective in this study was to test the safety feasibility of population.A total 33 undergoing via femoral, subclavian internal jugular access at two general medical-surgical intensive...

We conducted a prospective observational study to assess the efficacy of continuous venovenous hemofiltration (CVVH) with no anticoagulation. A standard anticoagulation protocol for CVVH, which prescribed patients at risk bleeding, was applied 48 critically ill treated CVVH. Circuit life prospectively observed, and following data were obtained each circuit: heparin use dose, protamine use, daily prothrombin time-international normalized ratio, activated partial thromboplastin time, platelet...

Objective To evaluate the efficacy and safety of a regional heparinization citrate method anticoagulation in CVVH. Design Randomized controlled cross-over study Subjects Ten critically ill patients with acute renal failure Setting ICU tertiary hospital Intervention CVVH was performed pre-filter fluid replacement at 2000ml/h blood flow rate 150ml/min. Regional by administration heparin 1500IU/h protamine post-filter 15mg/h. means citrate-based (14 mmol/L) administered pre-dilution. Results We...

Objectives Extended intermittent dialytic techniques are increasingly being reported in the treatment of ARF ICU but few randomized controlled trials exist. We compared one such technique to a continuous renal replacement therapy with regard fluid removal and hemodynamics. Methods Sixteen critically ill patients were enrolled trial at tertiary hospital. eight three consecutive days either Daily Dialysis filtration (EDDf) or Continuous Veno-Venous Hemofiltration (CVVH) hemodynamics during...

Large multicentre studies of continuous renal replacement therapy (CRRT) in critically ill patients may influence its bedside prescription and practical application. Despite this, many aspects CRRT not be informed by evidence but remain a product clinician preference. Little was known about current practice Australia New Zealand it is if the from recent has been integrated into practice.A prospective online survey sent to intensive care unit medical nursing clinicians via three national...

To determine whether blood flow rate influences circuit life in continuous renal replacement therapy.Prospective randomized controlled trial.Single center tertiary level ICU.Critically ill adults requiring therapy.Patients were to receive one of two rates: 150 or 250 mL/min.The primary outcome was measured hours. Circuit and patient data collected until each clotted ceased electively for nonclotting reasons. Data circuits are presented as median (interquartile range) compared using the...

<b><i>Background:</i></b> The impact of hybrid dialysis therapies on amino acid (AA) balance in critically ill patients with acute kidney injury is unknown. <b><i>Methods:</i></b> We examined prospectively the AA extended daily diafiltration (EDDF). <b><i>Results:</i></b> studied 7 patients. clearances EDDF ranged from 21.6 ml/min (tryptophan) to 66.9 (taurine). loss was 4.2 (IQR 1.4–12.3) g/day and 4.5% protein intake...

Continuous renal replacement therapy (CRRT) is intended to function continuously and prescribed for this outcome. Anticoagulants may not always be used. Clotting clogging within the CRRT filter stopping occurs with a variability in total elapsed time associated. This commonly known as circuit or “life”. It very useful important record at bedside refer measure of success quality. Filter life (i.e., hours) reported many reports investigating but well understood clear when considered inadequate...

Objective: The term continuous veno-venous haemofiltration (CVVH) suggests a treatment without interruption. However, interruptions do occur and the duration of circuit "down-time" may influence uraemic control. We conducted prospective study to ascertain percentage operative for CVVH in our intensive care unit test hypothesis that it significantly affected Patients methods: Prospective data measuring time spent off filter ten patients receiving were collected. Continuous was performed at 2...

Prolonged daily intermittent renal replacement therapy (PDIRRT) has been proposed as a new form of treatment for severe acute failure (ARF). However, this so far implied a) full dependence on nephrological input, b) lack any convective clearance and c) limited purification dialysate water. The aim study was to establish the feasibility safety performing PDIRRT in ICU with no addition some on-line fluid advanced water system.Prospective observational study.Fourteen patients treated PDIRRT.ICU...

Continuous renal replacement therapy (CRRT) can be used to treat hyperammonaemia. However, no study has assessed the effect of different CRRT techniques on ammonia clearance.We compared 3 in adult patients with hyperammonaemia, liver failure, and acute kidney injury. We protocolized progressively deliver continuous veno-venous haemofiltration (CVVH), haemodialysis (CVVHD) or haemodiafiltration (CVVHDF). Ammonia was simultaneously sampled from patient's arterial blood effluent fluid for each...

The removal of cytokines by standard hemofiltration is limited. Super high flux membranes may significantly improve even when used in dialysis mode. We sought to measure cytokine clearance using a large surface super high-flux membrane and hemodialysis setting.ICU laboratory tertiary institution.Six healthy volunteers.Blood form volunteers was incubated for 4 hours with E. coli endotoxin stimulate production. Cytokine containing blood then circulated through circuit at 3 different dialysate...

Objective: To present a review on the use of prolonged intermittent renal replacement therapy in intensive care patient. Data sources: Articles and abstracts reporting therapy. Summary review: Standard haemodialysis (IHD) has significant shortcomings treatment acute failure (ARF) critical illness. These include haemodynamic instability, need to remove excess fluid over short period time, episodic nature small solute control, limited ability achieve middle molecular weight control acid-base...

Aims To assess the safety and efficacy of two different commercial citrate containing pre-filter replacement fluids during continuous veno-venous hemofiltration (CVVH) in patients with frequent filter clotting. Setting: Four intensive care units. Patients: Sixty-three critically ill acute renal failure (ARF). Design: Prospective observational study. Methods We used a fluid (citrate: 11 mmol/L - A) as predilution for CVVH. then changed to new 14 mmol/L-fluid B) performed statistical...

Failure of extracorporeal circuit (EC) function during continuous renal replacement therapy (CRRT) appears most likely due to progressive clotting or, in some cases, mechanical problems that affect flow. We aimed study the incidence such failure (MCF).Retrospective observational an adult ICU a tertiary hospital.We studied 30 patients treated with CRRT via femoral vein vascular access. obtained information on age, gender, diagnosis, mode CRRT, life, and blood chemistry. defined MCF as...

Purpose: The choice of vascular access catheter may affect filter life during continuous renal replacement therapy (CRRT). In particular, differences in design might the incidence circuit clotting related to malfunction. Design and setting: Sequential controlled study a tertiary, adult intensive care unit (ICU). Aim: To compare when CRRT was performed with Niagara™ or Medcomp™ catheter. Patients measurements: We studied 46 patients acute kidney injury requiring CRRT, all delivered catheters...

<b><i>Background:</i></b> Continuous renal replacement therapy (CRRT) technique may affect circuit lifespan. A shorter life reduce CRRT efficacy and increase costs. <b><i>Methods:</i></b> In a before-and-after study, we compared median survival time during continuous venovenous hemofiltration (CVVH) versus hemodialysis (­CVVHD). We performed log-rank mixed effects univariate analysis Cox effect regression modeling to define predictors of...

The continuous renal replacement therapy (CRRT) bubble trap chamber is a frequent site of clotting.To assess clot formation when comparing our standard 'vertical' blood entry (BEC) with new 'horizontal' BEC.Adult ICU patients requiring CRRT were treated the vertical BEC and then similar subsequent cohort horizontal in veno-venous haemofiltration mode.40 chambers assessed for each design. Circuit life was 13.9 ± 9.5 h 17.7 15.9 (p = 0.33). APTT, however, higher (55.7 34.7 vs. 37.4 9.0, p <...