Continuous Arteriovenous Haemodialysis in Severe Combined Renal and Respiratory Failure

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Abstract
Continuous arteriovenous haemodialysis was used in 33 patients who also required ventilation. The mean daily urea and creatinine clearances were 20 and 16 ml/min, respectively, with dialysate flows of around 1 1/h. Such dialysis technique allows full nutritional support, less haemodynamic instability, and the ability to remove excess body and lung water swiftly. APACHE scoring after resuscitation did not separate the survivors from those who did not. Continuous anticoagulation and the use of lactate buffer need regular monitoring, but provide no extra hazard. For the first time in our experience, the mortality of a sequential series of patients with two-organ failure at least approaches 50%. If this is maintained, it becomes a very cost-effective regimen.

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