Effects of two different methods of initiating continuous veno-venous hemofiltration on the mean arterial pressure variation

Ioana Ghiţescu¹, Sanda Maria Copotoiu¹, Roxana Toma², L. Azamfirei¹

1. Disciplina A.T.I.,Universitatea de Medicina şi Farmacie Târgu Mureş, Clinica A.T.I., Spitalul Clinic de Urgenţă Mureş
2. Clinica A.T.I., Institutul de Boli Cardiovasculare şi Transplant, Târgu Mureş

Abstract

Background and objective The variation of mean arterial pressure (MAP) when initiating continous renal replacement therapies is poorly studied in the related literature. We described two different modalities of initiating the continuous veno-venous hemofiltration therapy (CVVH): type I - connecting sequentialy the arterial and the venous lines to the catheter,; type II - connecting both lines simultaneously, and we analised the MBP variation for15 minutes after the start of the therapy.

Method. Prospective interventional study, including 30 patients randomised for type I and type II method, in two comparable groups: group 1: n=16, type I; group 2: n=14, type II. We considered as significant variation of MAP a decrease of at least 20% of the initial value.

Results. The hemodinamically stable patients had no statistically significant variation of MAP when comparing the two methods (p = 0.45, CHI test). The hemodinamically unstable patients showed a better stability of MAP when CVVH was initiated with type II method (p = 0.01, Chi test). Conclusion. Initiating CVVH in hemodinamically unstable patients using type II method (coupling both lines simoultaneously to the catheter) offers a better hemodinamic stability, the variation of MAP being < 20%, and allows to start the therapy with no delay, under safe conditions.

Key words: continuous hemofiltration, critically ill, mean arterial pressure

studii clinice

Studiul variaţiei tensiunii arteriale medii la iniţierea hemofiltrării continue veno-venoase în două variante tehnice de lucru

Jurnalul Român de Anestezie Terapie intensivă 2007 Vol.14 Nr.1, 7-12