2011 Volume 2 Issue 1 Pages 136-140
We present a case of septic shock complicated by acute kidney injury in a patient with a left ventricular assist system (LVAS) that was successfully treated with high flow-volume continuous hemodiafiltration (CHDF). The patient was a 62-year-old man with a LVAS installed to treat low output syndrome following an acute myocardial infarction. During hospitalization, an infection developed near the inlet/outlet conduits. We controlled the infection with open drainage, but he was transferred to the intensive care unit (ICU) for septic shock upon fever onset and rapid deterioration of general conditions. Hemodynamics did not improve with early goal-directed therapy (EGDT). The patient’s condition was also complicated by acute kidney injury；therefore, we quickly introduced high flow-volume CHDF at three times the normal volume, which improved the hemodynamics. Six hours later, hemodynamics were stable and catecholamine reduction became possible；therefore, the patient was transitioned to standard CHDF. Subsequently, progress was satisfactory, and on the sixth day the patient left the ICU. Our findings suggest that high flow-volume CHDF may improve hemodynamics for septic shock that is complicated by acute kidney injury and is unresponsive to EGDT.
