INTRODUCTION Severe sepsis and septic shock are the primary causes of multiple organ dysfunction syndrome (MODS), which is the most frequent cause of death in intensive care unit patients. Many pro- and anti-inflammatory mediators, such as interleukin-6 (IL-6), play a strategic role in septic syndrome. Continuous renal replacement therapy (CRRT) removes in a nonselective way pro- and anti-infla...

INTRODUCTION Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury (AKI), and levels reflect severity of disease in critically ill patients. However, continuous venovenous hemofiltration (CVVH) may affect plasma levels by clearance or release of NGAL by activated neutrophils in the filter, dependent on the anticoagulation regimen applied. We therefore studied h...

We read with great interest the article by Rocco and colleagues [1] that retrospectively evaluated risk factors for acute kidney injury in critically ill patients receiving colistin and the subsequent comments by Rachid and colleagues [2]. Although of considerable interest, we would like to challenge the paper by Rocco and colleagues regarding the administered colistin loading and maintenance d...

BACKGROUND Citrate, the currently preferred anticoagulant for continuous veno-venous hemofiltration (CVVH), may influence acid-base equilibrium. METHODS The effect of 2 different citrate solutions on acid-base status was assessed according to the Stewart-Figge approach in two consecutive cohorts of critically ill adult patients. The first group received Prismocitrate 10/2 (PC10/2; 10 mmol cit...

INTRODUCTION D ialysis therapy for patients with severe hyponatremia is challenging because rapid correction of the serum sodium concentration may lead to osmotic demyelination syndrome (ODS). Gradual correction of hyponatremia is recommended to prevent hazardous sequelae. Continuous venovenous hemofiltration (CVVH) with low-sodium replacement solution can be used to prevent rapid correction of...

The pharmacokinetics of cefepime were studied in 12 adult patients in intensive care units during continuous venovenous hemofiltration (CVVH) or continuous venovenous hemodiafiltration (CVVHDF) with a Multiflow60 AN69HF 0.60-m(2) polyacrylonitrile hollow-fiber membrane (Hospal Industrie, Meyzieu, France). Patients (mean age, 52.0 +/- 13.0 years [standard deviation]; mean weight, 96.7 +/- 18.4 k...

BACKGROUND The systemic inflammatory response syndrome (SIRS) is characterized by a hypercatabolic state induced by inflammatory mediators. Continuous venovenous hemofiltration (CVVH) stabilizes the internal environment but also aggravates loss of amino acids. The effect of CVVH on protein dynamics is largely unknown. We adopted the stable isotopic tracer technology to investigate how CVVH chan...

Methotrexate (MTX) is used to treat various disorders and can be safely administered at high doses if renal function is adequate, high urine output (UOP) is maintained, urine is alkalinized and leucovorin rescue is given. Despite those measures, toxicity (mucositis, diarrhea, renal dysfunction and myelosuppression) occurs with prolonged high serum drug concentrations [1]. Dialysis-based methods...

Ultrafiltration by continuous venovenous hemofiltration (CVVH) is a well-established therapy for acute decompensated heart failure (ADHF). Aggressive fluid removal, however, may worsen the symptoms or even inflict de novo organ dysfunctions especially in the hemodynamically unstable patients. We described the incorporation of CVVH and impedance cardiography (ICG) in the management of an ADHF pa...

High-dose methotrexate (MTX) can produce acute kidney injury, impairing MTX elimination. Continuous venovenous hemofiltration (CVVH) may enhance elimination in this setting, although its use is largely unstudied. A 79-year-old man received IV MTX for central nervous system lymphoma, and over a 34-h period his serum creatinine increased from 1.09 to 2.24 mg/dL. His serum MTX concentration (sMTX)...