Continuous, high volume, venous-venous haemofiltration was used as renal support in 28 critically ill patients with acute renal failure. Fifteen patients survived and were subsequently discharged from the ITU. Although haemofiltration was highly effective in reducing the blood urea and serum creatinine, only survivors demonstrated a significant increase in arterial pH (medians before and at two days 7.28 and 7.49 respectively, p less than 0.005) with a reduction in severity of their illness (median APACHE II scores before and at two days 23 and 16, p less than 0.005). Patients who died remained severely ill and acidotic (median APACHE II scores before and at two days 26 and 28; median arterial pH values 7.32 and 7.31 respectively) and by day two of treatment, marked differences between the patient groups in APACHE II scores, mean arterial pressure, arterial pH and urine flow rate had developed. Haemofiltration with the correction of acute uraemia alone does not necessarily lead to a reduction in the severity of illness which in the critically ill more frequently reflects other organ dysfunction.

Acute Kidney Injury↗

PubMed1989

On the demise of the artificial liver.

Explore the source record for details and available documents.

Charcoal↗

PubMed1985

Stress ulceration in the critically ill patient.

Stress ulceration is common in patients receiving intensive care. Its cause is ill defined, life threatening complications are rare but the use of H2 antagonists and antacids in prophylaxis is widespread. The development of haemorrhage and perforation appears to be related to a group of risk factors of which sepsis may be the most important.

Antacids↗