Abstract

Continuous hemofiltration (CHF) is an extracorporeal process in which fluid electrolytes and other lower molecular weight substances are removed from the patient by ultrafiltration over an extended period. There are several kind of small handy commercially available hemofilters. This device requires only a small amount of blood flow rate (20-70 ml/min) for effective hemofiltration so we applied CHF for various patients who needed dialysis but whose clinical condition precluded either hemodialysis or peritoneal dialysis. 8 patients were treated. 6 were extremely unstable hemodynamically (mean BP around 60mmHg) and 4 were not indicated for peritoneal dialysis because of abdominal pathologies. Angioaccess was by percutaneous needle puncture artery and venous catheterization or Scribner shunt. Average duration of CHF was 55 hours ranging 24-96 hours. Hemofiltration rate were about 3-12 ml/min. Chemical composition of filtrate was same as plasma except very low protein and protein-bound substances. Removal of urea was 5-17 Gms/24hrs. Fluid loss from CHF was replaced by volume to volume. For 4 patients with massive fluid overload volume replacement was restricted to none to I/2 of this filtrates, ln these 4 patients, average about 2,000ml/24hrs of negative fluid balances were achieved without significant hemodynamic alteration. CHF is a simple, safe and effective treatment for acute renal failure and volume overloaded patients who are not indicated for either hemodialysis or peritoneal dialysis due to their conditions.