Abstract
Continuous hemofiltration (CHF) was performed in 11 patients with renal failure and hemodynamic instability. Blood access was obtained with a FDL catheterinserted from the subclavian vein. Blood flow was maintainedbya blood pump. Ultrafiltration rates of over 800ml/hr were obtained by control of blood flow with the pump and the pressure of the venous line. Substitution fluid was infused using an infusion pump while monitoring systemic blood pressure, central venous pressure, heart rate, and pulmonary arterial pressure. Four patients were successfully weaned from CHF. In one patient, CHF was replaced with hemodialysis after the hemodynamics became stable. Six patients died of cardiac pump failure. Our clinical findings suggest that CHF can be introduced and maintained without markedly affecting hemodynamics, and it prevents the significant increase in serum BUN and creatinine levels during the acute phase of renal failure. CHF appears to be a useful procedure for the treatment of renal failure especially in patients with unstable hemodynamics.
