Volume 1 Supplement 1

17th International Symposium on Intensive Care and Emergency Medicine

Open Access

Effects of the continuous venovenous haemofiltration, in the haemodynamic profile of shock septic patients

  • E Lafuente1,
  • A Marinho1,
  • A Bartolo1 and
  • R Milheiro1
Critical Care19971(Suppl 1):P068

DOI: 10.1186/cc65

Published: 1 March 1997

Introduction

Septic shock in spite of the new therapeutic strategies. still has a high mortality. There are multiple factors. and we may consider that the main objectives are the recovery of cardiovascular function and haemodynamic stability. Venovenous haemofiltration (CVVH), a technique used in septic patients with renal failure is now proposed in septic shock without renal failure. We studied the haemodynamic effects of the CVVH in septic shock patients that had not responded to high doses of catecholamines.

Materials and methods

We made continuous venovenous haemofiltration in eight patients with septic shock, after trying to control (the situation with fluid replacement and high doses of catecholamines. We used the blood pump MB10, a Gambro poliamide filter FH77 to attain an ultrafiltration higher then 2000 ml/h. We monitored all the patients with a thermodilution catheter, and we evaluated the haemodynamics and the O2 profile before the beginning of the CVVH, 12–24 h and 24–48 h after.

Results

The data are reported as mean and standard deviation. We made 224 evaluations of the haemodynamic and O2 profile on the eight patients included in this study.

Conclusion

CVVH improves the haemodynamic function in septic shock patients, confirmed by the rise of PAM, IC and of the LVSWI. Haemodynamic stability after 12 to 24 h of haemofiltration, allowed a reduction in the catecholamines doses, and withdrawal from shock criteria. We think that CVVH may be one valid alternative to control and treat the haemodynamic anomalies in patients with septic shock.

Table

n = 8

CI

MAP

PWCP

SVR

PVR

LVSWI

VO2

DO2

Before

3.8 ± 0.8

52.2 ± 2.8

15.6 ± 6.3

610 ± 222

117 ± 72

25.5 ± 9

119 ± 43

455 ± 130

12-24 h

4.3 ± 1.4

   88 ± 19

14.2 ± 4

999 ± 367

107 ± 37.9

37.6 ± 13.1

158 ± 28

555 ± 246

24-48 h

4.6 ± 0.8

89.3 ± 19.1

   17 ± 4.2

766 ± 332

113 ± 51.8

   48 ± 15.1

156 ± 18.5

529 ± 95.9

CI, cardiac index; MAP, median arterial pressure; PWCP, pulmonary wedge capillary pressure; SVR, systemic vascular resistance; PVR, pulmonary vascular resistance; LVSWI, left ventricular stroke work index; VO2, oxygen consumption; DO2, oxygen and delivery.

Authors’ Affiliations

(1)
UClP, HSO

Copyright

© Current Science Ltd 1997

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