Abstract
Ex vivo and in vivo studies on continuous arteriovenous hemofiltration (CAVH) were carried out using two different hemofilters: Diafilter-20 (Amicon, Mass, USA) and PAN-50P (Asahi Medical, Tokyo, Japan). The ultrafiltration rate (UFR) and sieving coefficient (SC) were obtained from dogs in which uremia was induced by bilateral ureteral ligation. UFR was entirely dependent on blood flow (Qb) and the pressure difference between hydrostatic transmembrane pressure (TMPH) and protein oncotic pressure, and it inversely correlated with hematocrit. SC for urea, creatinine and electrolytes was 1.0, and that for inulin was 0.8. No deterioration of UFR or SC for inulin wass observed with operation under spontaneous pressure difference. When CAVH, slow continuous ultrafiltration (SUF) and continuous hemofiltration (CHF) were applied to patients with overhydration who were resistant to conventional therapies and to those with multiorgan failure including acute renal failure, the clinical effectiveness was excellent in the patients with intractable overhydration and cardiac failure. Although mortality of the patients with multiorgan failure was still more than 75%, the control of these patients was better with CAVH and CHF. Therefore, these methods have better therapeutic potential in controlling multiorgan failure including acute renal failure.
