Influence of continuous hemofiltration on the hemodynamics of trauma patients

Riera, Jose A.S-Izquierdo; Alted, E.; Lozano, Maria José Santiago; Pérez, Jose L; Ambrós, Alfonso; Caballero, R. García

doi:10.1016/s0039-6060(97)90331-7

Cited by 19 publications

(7 citation statements)

References 23 publications

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“…In addition, the stable ITBVI, CI, and SVRI and the decrease in norepinephrine dose demonstrate improved fluid responsiveness in the ECVVH group. CVVH stabilized hemodynamics in critically ill patients [39], and the effect could be associated with the suppression of inflammation and the removal of cytokines [14]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome

Meng

Lai

et al. 2016

BioMed Research International

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Objective. To investigate the effects of 72-hour early-initiated continuous venovenous hemofiltration (ECVVH) treatment in patients with septic-shock-induced acute respiratory distress syndrome (ARDS) (not acute kidney injury, AKI) with regard to serum E-selectin and measurements of lung function and hemodynamic stability. Methods. This prospective nonblinded single institutional randomized study involved 51 patients who were randomly assigned to receive or not receive ECVVH, an ECVVH group (n = 24) and a non-ECVVH group (n = 27). Besides standard therapies, patients in ECVVH group underwent CVVH for 72 h. Results. At 0 and 24 h after initiation of treatment, arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio, extravascular lung water index (EVLWI), and E-selectin level were not significantly different between groups (all P > 0.05). Compared to non-ECVVH group, PaO2/FiO2 is significantly higher and EVLWI and E-selectin level are significantly lower in ECVVH group (all P < 0.05) at 48 h and 72 h after initiation of treatment. The lengths of mechanical ventilation and stay in intensive care unit (ICU) were shorter in ECVVH group (all P < 0.05), but there was no difference in 28-day mortality between two groups. Conclusions. In patients with septic-shock-induced ARDS (not AKI), treatment with ECVVH in addition to standard therapies improves endothelial function, lung function, and hemodynamic stability and reduces the lengths of mechanical ventilation and stay in ICU.

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Section: Discussionmentioning

confidence: 99%

Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome

Meng

Lai

et al. 2016

BioMed Research International

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“…Two trials reported hemodynamic descriptive analysis stability [6, 7]. Riera et al 1997 [7] reported that there is a significant improvement in mean arterial pressure (80 ± 9 to 94 ± 8 mmHg, P = 0.01) and partial pressure of oxygen in arteria blood/inspiratory oxygen supply index (124 ± 40 to 204 ± 44, P = 0.03) in the intervention group during the study period.…”

Section: Resultsmentioning

confidence: 99%

“…Riera et al 1997 [7] reported that there is a significant improvement in mean arterial pressure (80 ± 9 to 94 ± 8 mmHg, P = 0.01) and partial pressure of oxygen in arteria blood/inspiratory oxygen supply index (124 ± 40 to 204 ± 44, P = 0.03) in the intervention group during the study period. Sander et al 1997 [6] reported the mean arterial pressure and systemic vascular resistance index tended to increase in the hemofiltration group, but not in the control group.…”

Section: Resultsmentioning

confidence: 99%

The Effects of Continuous Blood Purification for SIRS/MODS Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2012

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Background. Continuous veno-venous hemofiltration (CVVH) has aroused great concern in recent years because its effect on clearing inflammatory mediators and its mechanism of clinical effects in the treatment of critical illness has also become a research direction. Objective. To evaluate the efficacy of continuous blood purification for systemic inflammatory response syndrome (SIRS)/multiple organ dysfunction syndrome (MODS) patients. Methods. A systematic review of the literature was undertaken to assess randomized controlled trials on CVVH. Results. 11 RCTs involving a total of 414 patients were included. Compared with the control group, CVVH for SIRS/MODS patients has several advantages including better effects on clearing the plasma inflammatory mediators IL-6 [SMD3d = −0.45, 95%CI, (−0.83, −0.07), SMD7d = −1.07, 95%CI, (−1.52, −0.62)], on plasma TNF-alfa [SMD3d = −0.87, 95%CI, (−1.69, −0.04), SMD7d = −1.42, 95%CI, (−2.49, −0.35)], lower white blood cell (WBC) count [MD = 2.61, 95%CI, (1.49, 3.73)], shorter hospital stays [MD = −7.21 days, 95%CI, (−10.68, −3.74)] and better stability of hemodynamics. However, there is no significant difference in the mortality rate [MODS:RR = 0.62, 95%CI, (0.38, 1.01), SIRS:RR = 0.75, 95%CI, (0.57, 1.08)]. Conclusions. The study showed that CVVH was able to eliminate inflammatory mediators (TNF-alfa, IL-6) in plasma effectively, lower WBC count and shorter hospital stays than conventional therapeutic measures.

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“…CHDF, on the other hand, is useful for renal support. Recently, however, CHDF draws the attention not merely as continuous renal replacement therapy (CRRT) but also it begins to be applied under non-renal implication [7,12]. We have often experienced unexpected improvement of hemodynamics with CHDF even when it is performed for renal support.…”

Section: Discussionmentioning

confidence: 99%

“…was effective in improving hemodynamics in patients with renal failure and trauma, respectively [6,7]. Currently, however, there are still few study results regarding the efficacy of CHDF for congestive heart failure in critical situations.…”

mentioning

confidence: 99%

Efficacy of Continuous Hemodiafiltration for Patients with Congestive Heart Failure

Nakanishi

Hirasawa²,

Sugai³

et al. 2002

Blood Purif

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Background/Aims: The basic principle of treatment of congestive heart failure is achieving adequate control of preload and afterload through enhancement of cardiac contractility. In severe cases, however, we have usually applied continuous hemodiafiltration (CHDF) as a type of mechanical support. In this study, we investigated hemodynamic changes caused by CHDF in patients with congestive heart failure. Methods: We treated seven patients with congestive heart failure complicated by multiple organ failure by CHDF over 72 h, during which we measured hemodynamic parameters to determine their changes. Results: Implementation of CHDF resulted in a significant decrease in pulmonary artery occluded pressure and significant increases in cardiac index and left ventricular stroke work index. In addition, 72-hour cumulative water balance was found to be –1,791 ± 2,119 ml, and systemic vascular resistance index decreased significantly. Conclusion: Hemodynamics of patients were improved with CHDF through strict control of preload and consequently tissue oxygen metabolism was improved.

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Influence of continuous hemofiltration on the hemodynamics of trauma patients

Cited by 19 publications

References 23 publications

Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome

Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome

The Effects of Continuous Blood Purification for SIRS/MODS Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy of Continuous Hemodiafiltration for Patients with Congestive Heart Failure

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