Experience with inline intermittent hemodiafiltration as renal replacement therapy in critically ill patients

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dc.contributor.authorBarrios Araya, Silvia
dc.contributor.authorEspinoza Coya, Maria Elisa
dc.contributor.authorNunez Gomez, Kelly
dc.contributor.authorSepulveda Palamara, Rodrigo
dc.contributor.authorMolina Munoz, Yerko
dc.date.accessioned2025-01-23T21:12:15Z
dc.date.available2025-01-23T21:12:15Z
dc.date.issued2019
dc.description.abstractBackground: In critical patients with acute renal failure, intermittent diffusive renal replacement techniques cause hemodynamic problems due to their high depurative efficiency. This situation is avoided using continuous low efficiency therapies, which are expensive, prevent patient mobilization and add hemorrhagic risk due to systemic anticoagulation. Intermittent and prolonged hemodiafiltration (HDF) has the depurative benefits of diffusion, plus the positive attributes of convection in a less expensive therapy. Aim: To report our experience with intermittent and prolonged on-line HDF in critically ill patients. Patients and Methods: During 2016, HDF therapies performed on critical patients with indication of renal replacement therapy were characterized. The hemodynamic profile was evaluated (doses of noradrenaline, blood pressure, heart rate and perfusion parameters). Results: Fifty-one therapies were performed in 25 critical patients, aged 58 +/- 11 years (28% women), with an APACHE II score of 22.1 +/- 10. The average time of the therapies was 4.15 hours (range 3-8 hours), the replacement volume was 75 +/- 18 mL/kg/h and ultrafiltration rate was 226 +/- 207 mL/h. The mean initial, maximum and final noradrenaline doses were 0.07 +/- 0.1, 0.13 +/- 0.18 and 0.09 +/- 0.16 mu g/kg/min respectively. No differences between patients with low, medium and high doses of noradrenaline or dose increases during therapy, were observed. The greatest decrease in mean arterial pressure was 15.3% and the maximum increase in heart rate was 12.8%. Anticoagulation was not required in 88% of therapies. Conclusions: High-volume intermittent or prolonged HDF is an effective therapy in critical patients, with good hemodynamic tolerability, lower costs and avoidance of systemic anticoagulation risks.
dc.fuente.origenWOS
dc.identifier.eissn0717-6163
dc.identifier.issn0034-9887
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/100947
dc.identifier.wosidWOS:000472530400002
dc.issue.numero4
dc.language.isoen
dc.pagina.final415
dc.pagina.inicio409
dc.revistaRevista medica de chile
dc.rightsacceso restringido
dc.subjectAcute kidney injury
dc.subjectCritically Ill
dc.subjectHemodiafiltration
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleExperience with inline intermittent hemodiafiltration as renal replacement therapy in critically ill patients
dc.typeartículo
dc.volumen147
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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