Continuous arteriovenous hemofiltration as an adjunctive therapy for septic shock.

The effects of continuous arteriovenous hemofiltration were studied in septic patients with acute renal failure and gross fluid overload. Hemofiltration was performed for a mean of 7 days per patient (range 1 to 14 days). The mean filtration volume was 3.64 L/day. The mean total ultrafiltration volume per patient was 25.5 L. The patients were hemodynamically stable during hemofiltration, as indicated by measurements of arterial blood pressure, CVP, pulmonary artery pressure, pulmonary artery wedge pressure, and cardiac output. Multiple simultaneous measurements in both serum and ultrafiltrate showed a very close correlation for sodium, potassium, phosphorus, urea and creatinine levels. There was no detectable protein in the ultrafiltrate. The calcium concentration in the ultrafiltrate was relatively low. Finally, antibiotic levels in the ultrafiltrate were almost equal to serum levels. There were no significant complications; in this series of patients hemofiltration was a safe and effective treatment of fluid overload.