Document Detail


Operating characteristics of pediatric continuous arteriovenous hemofiltration in an animal model.
MedLine Citation:
PMID:  8476717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Continuous arteriovenous hemofiltration (CAVH) is an increasingly popular technique in the care of critically ill children. The operating characteristics of the available circuits are largely unknown. Prior to introducing CAVH into our pediatric intensive care unit, we investigated the performance of three CAVH circuits: CAVH with postfilter dilution, CAVH with prefilter dilution (CAVHpre) and CAVH with dialysis counterflow. Using a neonatal lamb model, we measured filter blood flow (QB), ultrafiltrate rate (QU), arterial, venous and ultrafiltrate compartment pressures, oncotic pressure, plus urea levels in blood and ultrafiltrate fluid for the three CAVH circuit designs. Transmembrane pressure and urea clearance were calculated for various values of QB after varying a clamp on the arterial side of the circuit. The major finding, applicable to all circuits, was the wide variability of QB. Constant attention was required in order to obtain a consistent QB. Fluid clearance was effective with all three circuits. Urea clearance averaged 5-10 ml/min and was principally dependent on QU and independent of QB. The addition of dialysis counterflow did not increase urea clearance. The most convenient circuit we tested was CAVHpre, but the problem of unstable QB is common to all unpumped arteriovenous filtrate circuits. It is a major limiting factor in the practical application of this technology to critically ill children.
Authors:
H A Werner; M J Herbertson; M D Seear
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  7     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-21     Completed Date:  1993-05-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  189-93     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, British Columbia's Children's Hospital, Vancouver, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity / physiology
Child
Disease Models, Animal
Hemofiltration / instrumentation,  methods*
Humans
Intensive Care Units, Pediatric
Sheep
Ultrafiltration / methods
Urea / pharmacokinetics
Chemical
Reg. No./Substance:
57-13-6/Urea

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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