Effect of continuous venovenous hemofiltration with dialysis on lactate clearance in critically ill patients

Levraut, J.; Ciebiera, Jean-Pierre; Jambou, P.; Ichaï, Carole; Labib, Yasser; Grimaud, D.

doi:10.1097/00003246-199701000-00013

Cited by 124 publications

(65 citation statements)

References 22 publications

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“…Some investigators have suggested the lactate removal by CHDF per se. However, it was reported that the blood lactate concentration remains a reliable marker of tissue oxygenation even during CHDF [22]. …”

Section: Discussionmentioning

confidence: 99%

Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in Patients with Septic Shock: A Preliminary Report

et al. 2014

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Background/Aim: We investigated the clinical efficacy of continuous hemodiafiltration (CHDF) with AN69ST hemofilter (AN69ST-CHDF) in patients with septic shock. Materials and Methods: A prospective, multicenter, single-arm study was conducted. Patients with sepsis and shock defined by hyperlactemia were enrolled. The patients were treated with CHDF and in accordance with the Surviving Sepsis Campaign guidelines (SSCG). Results: Thirty-four patients were enrolled. On ICU admission, the mean blood IL-6 level was 44,800 ± 77,700 pg/ml, and the mean blood lactate level was 69.0 ± 49.4 mg/dl. Both the mean blood IL-6 and lactate levels had significantly decreased to normal ranges after 72 h of AN69ST-CHDF. Though the mean APACHE II score was 32.7 ± 9.8, 28-day survival was 73.5%. Conclusion: The current study suggested that adding AN69ST-CHDF to the treatments outlined in the SSCG might lead to good outcomes for patients with septic shock, probably via the removal of cytokines from the bloodstream.

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Section: Discussionmentioning

confidence: 99%

Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in Patients with Septic Shock: A Preliminary Report

et al. 2014

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“…A recent study looked at lactate elimination in 10 patients with acute renal failure who were on continuous venovenous hemodiafiltration. In the absence of lactic acidosis endogenous lactate clearance did not appear to be impaired; however, the filter clearance of lactate accounted for only 2.4% of the overall lactate clearance [9]. There is limited information on the clearance of lactate in the setting of lactic acidosis.…”

Section: Principles Of Acid-base and Electrolytes Management In Crrtmentioning

confidence: 97%

“…In the last 5 years there have been several publications commenting on the beneficial role of bicarbonate as buffer instead of lactate [8][9][10][11][12][13][14][15][16][17][18]. Use of lactate ions as base has been associated with an increase in urea generation [8].…”

Section: Principles Of Acid-base and Electrolytes Management In Crrtmentioning

confidence: 99%

“…Additionally the capacity to convert lactate to bicarbonate may be impaired in the setting of hypotension and multiple organ failure resulting in lactate accumulation [9]. Hilton et al [10] have shown that use of bicarbonatebased solutions is associated with improved hemodynamic stability although no difference was found by Thomas et al [11] comparing lactate-and bicarbonate-based solutions.…”

Section: Principles Of Acid-base and Electrolytes Management In Crrtmentioning

confidence: 99%

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Acid-Base and Electrolyte Management in Continuous Renal Replacement Therapy

Mehta¹

2002

Blood Purif

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Continuous renal replacement techniques are often utilized to manage acid-base and electrolyte problems in the critically ill patient. These techniques have an inherent capacity to manipulate the plasma composition and can be utilized efficiently to maintain homeostasis and metabolic control. Unfortunately, the efficacy of these techniques also permits wide variation in their use and can result in complications if they are not used appropriately. In most instances complications can be prevented by recognition of the operating principles and careful attention to detail. This article provides an overview of the principles of acid-base and electrolyte management with continuous renal replacement therapy.

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“…Some success has been reported in the treatment of combined renal failure and lactic acidosis with the use of continuous haemofiltration using lactate free dialysate [134]. This treatment does not mask lactate overproduction [135] and, in the face of sustained hyperlactataemia, an underlying diagnosis of fulminant hepatic failure or gangrenous bowel should be considered.…”

Section: Treatment Of Lactic Acidosismentioning

confidence: 99%

Anions and the anaesthetist

2002

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SummaryAnions are the negative components of most chemical structures and play many important physiological and pharmacological roles that are of interest to the anaesthetist. Their relevance is reviewed with a particular emphasis on the inorganic anions (halides, bicarbonate, phosphate and sulphate) and the significance and limitations of the anion gap. Organic anions (albumin, lactate) are also discussed, albeit briefly. The suitability of anions for their role in neurotransmission and acid2base balance is outlined.

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Effect of continuous venovenous hemofiltration with dialysis on lactate clearance in critically ill patients

Abstract: Continuous venovenous hemofiltration with dialysis cannot mask lactate overproduction, and its blood concentration remains a reliable marker of tissue oxygenation in patients receiving this renal replacement technique.

Cited by 124 publications

References 22 publications

Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in Patients with Septic Shock: A Preliminary Report

Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in Patients with Septic Shock: A Preliminary Report

Acid-Base and Electrolyte Management in Continuous Renal Replacement Therapy

Anions and the anaesthetist

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