[Automatic fluid control during high-flow continuous hemofiltration: the Equaline system].

OBJECTIVE

To describe the use of an automatic fluid control system, Equaline, during high flux continuous hemofiltration.

DESIGN

Prospective descriptive study.

SETTING

General intensive care unit in a general hospital.

PATIENTS

15 consecutive patients suffering from septic shock, hypercatabolic with acute renal failure.

INTERVENTION

Pump driven continuous veno-venous hemofiltration (PDCVVH) with high flux was performed. All pts were intubated, under mechanical ventilation and treated with vasoactive agents for hemodynamic instability. Fluid balance was achieved with an automatic fluid control system, Equaline, on daily basis according to clinical needs.

MEASURES

Length of treatment, daily amount of ultrafiltrate and urea removal, urea and creatinine blood level before and after the treatment were registered.

RESULTS

Age was 59.1 years, SAPS 17.2. Patients were treated for an average period of 9 days obtaining a daily ultrafiltrate production of 21.4 L. In all pts, though the high catabolism (daily nitrogen production > 30 g), there was a significant decrease of urea and creatinine concentration.

CONCLUSION

Equaline system was able to maintain intravascular volume in the face of high ultrafiltration rate avoiding clinically important discrepancies between ultrafiltrate formation and fluid replacement. We conclude that PDCVVH management is greatly improved with use of such servo-controlled feedback system.