Differential Indications for the Use of Continuous Arteriovenous Hemofiltration

Abstract

The number of publications and case reports on continuous arteriovenous hemofiltration (CAVH) has increased exponentially [1, 6-8] as a result of various reasons all related to clinical practice, including:

• 1. Overhydration resistant to diuretics is a common problem in all intensive care units and the resulting restriction of fluid administration or the time-consuming discussion about the indication of a hemodialysis is an unpleasant experience of most physicians and surgeons.

• 2. CAVH is a simple procedure, which may be started by any physician or surgeon who has experience with the Seidinger technique for insertion of femoral catheters.

• 3. The pumpless ultrafiltration driven by cardiac contraction force is not expected to work and thus impresses most withnesses of visible “urine output” of the artificial glomerulus more than do other innovations.

• 4. The new kidney replacement therapy has made it possible to treat patients in the specialist’s intensive care unit (hopefully with the nephrologist as a Consultant). Thus, various specialists such as general and thoracic surgeons, anesthesiologists and cardiologists eventually collected more practical experience with this method than did nephrologists.