Nahman N S, Middendorf D F
Department of Internal Medicine, Ohio State University Hospitals, Columbus.
Med Clin North Am. 1990 Jul;74(4):975-84. doi: 10.1016/s0025-7125(16)30530-2.
CAVH is a bedside form of dialysis that is used in the treatment of fluid and electrolyte disorders seen in critically ill patients. The major advantages of the procedure include (1) gradual, continuous therapy, which is ideal in hemodynamically unstable patients; (2) control of fluid balance; and (3) ease of administration in the ICU. The major disadvantages of CAVH include (1) a requirement for arterial access, (2) the need for anticoagulation, (3) the risks of infection from long-term indwelling vascular lines, and (4) the potential for significant volume depletion. The effectiveness of CAVH may continue to improve owing to technical developments in filter composition and the application of clinical tactics such as suction-assisted filtration, predilution fluid replacement, or regional heparinization. The next step in bedside dialysis is represented by CAVHD, which offers all of the advantages of CAVH as well as improved urea clearance.
连续性动静脉血液滤过（CAVH）是一种床边透析形式，用于治疗危重症患者出现的液体和电解质紊乱。该操作的主要优点包括：（1）渐进性、连续性治疗，这对于血流动力学不稳定的患者是理想的；（2）控制液体平衡；（3）在重症监护病房（ICU）易于实施。CAVH的主要缺点包括：（1）需要动脉通路；（2）需要抗凝；（3）长期留置血管导管有感染风险；（4）有显著容量耗竭的可能性。由于滤器成分的技术发展以及诸如负压辅助滤过、预稀释补液或局部肝素化等临床策略的应用，CAVH的有效性可能会持续提高。床边透析的下一步是连续性动静脉血液透析滤过（CAVHD），它具有CAVH的所有优点，并且提高了尿素清除率。
