Acute Continuous Renal Replacement Therapy

The initial observations of dialytic support were brought from the laboratory and confined to patients with reversible acute renal failure. The thought at that time was one of short term maintenance. It was theorized that removal of waste products from the blood, albeit incomplete and inefficient, might allow these patients time to regenerate damaged tubules and regain renal function. After a dis­ appointing earlier experience in survival, greater sophisti­ cation and broader practice refined the dialysis skills and reduced mortality. It also became apparent that long periods of support were possible and successful attempts were then made in utilizing this technology in patients with chronic renal failure. These early young patients were a very select group who possessed only renal dysfunction and no other systemic involvement. Nonetheless, they demonstrated a one year survival of only 55-64%. There are presently over 80,000 patients on dialytic support in the United States and over 250,000 patients worldwide dependent on artificial replace­ ment. Mortality statistics vary but despite a 20-30% systemic disease involvement and a fifth decade average age in the North American experience, the one year survival has risen to apparently 90%.

Contenu

1. Ultrafiltration/Hemofiltration Overview: Where Does Cavh Fit?.- 2. Continuous Replacement Modalities in Acute Renal Dysfunction.- 3. Transport in Continuous Arteriovenous Hemofiltration and Slow Continuous Ultrafiltration.- 4. The Practical Technical Aspects of Slow Continuous Ultrafiltration (SCUF) and Continuous Arteriovenous Hemofiltration (CAVH).- 5. Fluid Balance in Continuous Arteriovenous Hemofiltration.- 6. Hemofiltration and Ultrafiltration: Nursing Concerns.- 7. Hyperalimentation in Acute Renal Failure.- 8. Continuous Arteriovenous Hemofiltration-The Control of Azotemia in Acute Renal Failure.- 9. The Predilution Mode for Continuous Arteriovenous Hemofiltration.- 10. Nutrition in Acute Renal Failure: Treatment Made Possible by Continuous Arteriovenous Hemofiltration (CAVH).- 11. Drug Kinetics and Continuous Arteriovenous Hemofiltration.- 12. Continuous Arteriovenous Hemofiltration in Infants.- 13. Continuous Arteriovenous Hemodialysis-Laboratory Experience and Theory.- 14. Continuous Arteriovenous Hemodialysis-Clinical Experience.- 15. Continuous Ambulatory Peritoneal Dialysis in Acute Renal Failure.- 16. Continuous Arteriovenous Hemofiltration-Applications Other Than for Renal Failure.