TY - JOUR
T1 - Importance of increased ultrafiltration volume and impact on mortality
T2 - Sepsis and cytokine story and the role for CVVH
AU - Ronco, Claudio
AU - Ricci, Z.
AU - Bellomo, R.
PY - 2002
Y1 - 2002
N2 - There is growing interest in extracorporeal blood purification therapies (EBPT) as adjuvants in the complex therapy of sepsis and multiple organ dysfunction syndrome (MODS). Nowadays the only routinely used purification technique is 'renal replacement therapy' (RRT) during acute renal failure (ARF), one of the almost inevitable and deadly components of MODS. RRT has been the first and still is the most utilised and effective type of EBPT. Evidence is growing about its ability to maintain homeostatic balance in critically ill patients, and specifically in septic patients with MODS. Clinical trials have been recently designed to modify or improve these therapies. In detail, the following issues have been currently addressed: effects on blood purification provided by different therapies, adequacy of prescription and delivery of therapy, toxins and solutes to be removed with these techniques. Based on these speculations we will briefly review the current understanding of these issues and the rationale for application of RRT in the intensive care unit (ICU). In particular, we will focus on the importance of increased ultrafiltration volume and its impact on mortality in the general ICU population and in septic patients.
AB - There is growing interest in extracorporeal blood purification therapies (EBPT) as adjuvants in the complex therapy of sepsis and multiple organ dysfunction syndrome (MODS). Nowadays the only routinely used purification technique is 'renal replacement therapy' (RRT) during acute renal failure (ARF), one of the almost inevitable and deadly components of MODS. RRT has been the first and still is the most utilised and effective type of EBPT. Evidence is growing about its ability to maintain homeostatic balance in critically ill patients, and specifically in septic patients with MODS. Clinical trials have been recently designed to modify or improve these therapies. In detail, the following issues have been currently addressed: effects on blood purification provided by different therapies, adequacy of prescription and delivery of therapy, toxins and solutes to be removed with these techniques. Based on these speculations we will briefly review the current understanding of these issues and the rationale for application of RRT in the intensive care unit (ICU). In particular, we will focus on the importance of increased ultrafiltration volume and its impact on mortality in the general ICU population and in septic patients.
KW - Cytokine
KW - Mortality
KW - Renal replacement therapy
KW - Ultrafiltration
UR - http://www.scopus.com/inward/record.url?scp=0036363837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036363837&partnerID=8YFLogxK
M3 - Article
C2 - 12371715
AN - SCOPUS:0036363837
VL - 28
SP - 13
EP - 18
JO - Journal of Renal Care
JF - Journal of Renal Care
SN - 1019-083X
IS - SUPPL. 2
ER -