CONTINUOUS BLOOD PURIFICATION (CBP) IN CRITICALLY ILL PATIENTS

Abstract

The present study was undertaken to investigate the efficacy of CBP in critically ill patients. During past three years, CBP was performed on 65 patients. For anuric patients continuous hemofiltration (CHF) was effective to make nutritional management with TPN easier and to maintain water, electrolytes and acid-base balance. Another effect of CHF was the removal of causative mediators of organ failure. However CHF was not satisfactory to remove low molecular weight substances, and therefore intermittent hemodialysis (HD) was mandatory. Continuous hemodiafiltration (CHDF) was more effective than intermittent HD combined with CHF in the removal of low molecular weight substances. CHDF could be performed uneventfully under the use of nafamos tat mesilate as anticoagulant even during operation. The study on the reduction rate of creatinine in the relation to filtration rate during CHF and filtration rate+dialy sate flow during CHDF in dicates that it is possible to decrease creatinine level with more than 0.165 l/kg/day of filtrate in CHF and with more than 0.209 l/kg/day of filtrate+dialysate in CHDF. Continuous plasma exchange (CPE) could be performed safely an ffe tively on children and patients with hemodynamic unstableness. Continuous hemoadsorption (CHA) could remove amitryptilhne which widely distributed in organs. From these results we conclude that CBP is a first-choice blood purification in critically ill patients.