[Continuous arteriovenous hemofiltration (CAVH)]. 1982

T Stokke, and P Kramer, and J Schrader, and H J Gröne, and H Burchardi

The continuous arteriovenous haemofiltration (CAVH) is a simple, safe, inexpensive and personnel-saving method for treatment of uremic patients. Since the introduction of the CAVH in 1977, far more than 200 patients have been treated by this method in our hospital. In the present paper the method and our experiences during the clinical application are presented. The haemofilter is placed in an extracorporal shunt between the A. and V. femoralis. Cannulation of these vessels is performed by means of a modified Seldinger technique using commercially available catheter. During haemofiltration, heparin is infused into the arterial blood line at a rate of 10 IU/kg . h. The filtrate is totally or partially replaced by nutrition solutions, enteral or parenteral, and by a potassium-free Ringer's lactate i.v. solution, according to the required fluid balance. In most cases the filtrate-substitution rate will be high enough to compensate renal failure, and thus conventional dialysis methods will not be necessary. Clinical experience to date allows the following conclusions: optimal control of water and electrolyte balance; unlimited parenteral nutrition, continuous fluid withdrawal better tolerated than intermittent withdrawal by means of dialysis; low risk of local bleeding with skilled puncture technique of the femoral vessels. Low dose continuous heparin administration into arterial blood line is sufficient for extracorporal anticoagulation. Saving of expenses: No investment costs for machines; specially trained dialysis personnel superfluous.

UI MeSH Term Description Entries
D006955 Hypernatremia Excessive amount of sodium in the blood. (Dorland, 27th ed) Hypernatremias
D009846 Oliguria Decreased URINE output that is below the normal range. Oliguria can be defined as urine output of less than or equal to 0.5 or 1 ml/kg/hr depending on the age. Oligurias
D010710 Phosphates Inorganic salts of phosphoric acid. Inorganic Phosphate,Phosphates, Inorganic,Inorganic Phosphates,Orthophosphate,Phosphate,Phosphate, Inorganic
D001769 Blood The body fluid that circulates in the vascular system (BLOOD VESSELS). Whole blood includes PLASMA and BLOOD CELLS.
D004232 Diuretics Agents that promote the excretion of urine through their effects on kidney function. Diuretic,Diuretic Effect,Diuretic Effects,Effect, Diuretic,Effects, Diuretic
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006947 Hyperkalemia Abnormally high potassium concentration in the blood, most often due to defective renal excretion. It is characterized clinically by electrocardiographic abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur. (Dorland, 27th ed) Hyperpotassemia,Hyperkalemias,Hyperpotassemias
D014462 Ultrafiltration The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in DIALYSIS separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as HEMOFILTRATION or HEMODIAFILTRATION (if combined with HEMODIALYSIS).
D014511 Uremia A clinical syndrome associated with the retention of renal waste products or uremic toxins in the blood. It is usually the result of RENAL INSUFFICIENCY. Most uremic toxins are end products of protein or nitrogen CATABOLISM, such as UREA or CREATININE. Severe uremia can lead to multiple organ dysfunctions with a constellation of symptoms. Uremias

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