Continuous hemofiltration in 2009: what is new for clinicians regarding pathophysiology, preferred technique and recommended dose?

摘要: In the last years, publications have questioned classical dose of 35 ml/kg, but are those studies strong enough in terms scientific power order to change our practice? We will try settle some recommendations for clinicians. Manipulation dose, porosity, and combinations yielded promising findings. However, conclusive evidence based on randomized trials remains scarce, limiting practical implementation daily practice. From few designed studies, it is safe say that optimization delivered has a proven positive effect. An ultrafiltration rate around ml/kg/h, with adjustment predilution, can be recommended septic patient. Recent do not this recommendation view its shortcomings. Finally keep going continuous technique, pure veno-venous hemofiltration mode, at ml/kg/h while waiting other published.