Abstract
Objective
To investigate the influence of continuous haemofiltration (CHF) on haemodynamics, gas exchange and core temperature in critically ill septic patients with acute renal failure.
Patients and methods
In 20 patients (17 male, 3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic variables were measured at regular intervals during the first 48 h of haemofiltration. Baseline data were compared to those obtained 30 min after initiating CHF and also to those during hypothermia (if observed).
Main results
Haemodynamic variables remained remarkably constant throughout the study period. In patients with a relatively low ultrafiltration rate (855±278 ml/h) temperature did not change, while in patients with a high ultrafiltration rate (1468±293 ml/h) core temperature significantly decreased from 37.6±0.9°C to 34.8±0.8°C (p<0.001). There was a statistically significant correlation between temperature decrease and ultrafiltration rate (r=−0.68, Y=1.8−0.003 X,p<0.01). Hypothermic patients also showed a mean decrease in VO2 from 141±22 ml/min/m2 to 112±22 ml/min/m2 (p<0.01) with a concomitant increase in PaO2 from 103±37 mmHg to 140±42 mmHg (p<0.001) and in P\(\bar v\)O2 from 35±4 mmHg to 41±5 mmHg (p<0.001).Conclusions: 1) Continuous haemofiltration does not cause significant alternations in haemodynamic variables. 2) Hypothermia frequently occurs in patients undergoing continuous haemofiltration with high ultrafiltration rates. These hypothermic patients show a reduction in\(\dot V\)O2 leading to an increase in P\(\bar v\)O2 and PaO2. This mild hypothermia in these circumstances has no evident deleterious effects.
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Matamis, D., Tsagourias, M., Koletsos, K. et al. Influence of continuous haemofiltration-related hypothermia on haemodynamic variables and gas exchange in septic patients. Intensive Care Med 20, 431–436 (1994). https://doi.org/10.1007/BF01710654
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DOI: https://doi.org/10.1007/BF01710654