Kramer P, Schrader J, Bohnsack W, Grieben G, Gröne H J, Scheler F
Proc Eur Dial Transplant Assoc. 1981;18:743-9.
Twenty intensive care patients, who as an additional complication developed acute oliguric renal failure were treated solely with continuous arteriovenous haemofiltration (CAVH). The mean spontaneous filtration rate was 8.8 +/- 3.5ml/min. IV substitution of the ultrafiltrate by K+-free Ringer's lactate solution resulted in a steady state plasma creatinine level of 6.4 +/- 3.5mg/dl. Duration of treatment was three to 24 days (10.5 +/- 7.9 days). Eight patients recovered kidney function and survived. Clinical experience in five intensive care units with more than 150 applications of CAVH 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. With skilled puncture of the femoral artery there was no risk of bleeding. Low dose continuous heparin administration (10IU/kg/hr) into the arterial blood line is sufficient for extracorporeal anticoagulation. Haemofilters can be used for a long time (two to ten days). Specially trained dialysis personnel and investment costs for machines are not necessary.
20名重症监护患者因并发急性少尿性肾衰竭，仅接受持续动静脉血液滤过（CAVH）治疗。平均自发滤过率为8.8±3.5毫升/分钟。用无钾乳酸林格液静脉替代超滤液，使血浆肌酐水平稳定在6.4±3.5毫克/分升。治疗持续时间为3至24天（10.5±7.9天）。8名患者肾功能恢复并存活。5个重症监护病房超过150次应用CAVH的临床经验得出以下结论：能最佳控制水和电解质平衡；可进行无限制的胃肠外营养；持续排液比通过透析间歇性排液耐受性更好。熟练穿刺股动脉无出血风险。向动脉血路中低剂量持续输注肝素（10国际单位/千克/小时）足以进行体外抗凝。血液滤过器可长时间使用（2至10天）。无需专门培训的透析人员和机器投资成本。
