[Mechanisms of extracorporeal effects of hemofiltration on blood circulation in open heart surgery patients].

The parameters of central hemodynamics and oxygen balance were studied over the course of prolonged venovenous hemofiltration (VVHF) in 16 patients with the syndrome of multiorgan failure (acute renal, pulmonary, cardiovascular insufficiency and shock), which developed after open heart surgery. The measurements were carried out 3, 8, 16, and 25 h after VVHF was started. The rate of ultrafiltration was 30 to 60 ml/min. Stabilization of arterial pressure (diastolic and mean) and normalization of the total peripheral vascular resistance were observed in all the patients irrespective of the status of the central hemodynamics before hemofiltration session. The doses of catecholamines with the predominant vasopressor effect were reduced. Integrative parameters of cardiorespiratory delivery and consumption of oxygen were unchanged. Addition of VVHF to a complex of intensive care measures used in patients with the multiorgan failure syndrome helped attain satisfactory results in 9 (56%) patients. Seven (44%) patients died in various periods after VVHF, shock occurring in 6 of them.