Continuous renal replacement therapies for the treatment of acute renal failure in intensive care patients.

摘要: Continuous renal replacement therapies are extensively utilized for the treatment of acute failure in critically ill patient. The arterio-venous circulation has been partially substituted by veno-venous pump driven circulation. Diffusion added to convection order increase small solutes clearance even though sometimes pure is still advantageously utilized. Hemofilters have changed hemodiafilters with possibility countercurrent dialysate blood path geometry specifically designed operate under conditions low pressure and flow. Therefore lower amounts heparin required maintain extracorporeal anticoagulation a reduced risk bleeding. New techniques new materials permit us today carry out continuous rate complications an increased percentage survival among treated patients. improved understanding multiple organ syndrome pathophysiology septic syndrome, suggest newer indications therapies. proposed mechanisms action therapy should be removal chemical mediators such as platelet activating factor, interleukin-1 tumor necrosing factor alfa, not only filtration process, but also adsorption on surface structure artificial membrane. These may part responsible beneficial effects patients affected other dysfunctions.