NEW CRRT SYSTEMS - IMPACT ON DOSE DELIVERY

The evolution of technology and biomaterials has permitted a parallel development of renal replacement therapies in the acute, critically il l patient, From the original description of continuous arteriovenous h emofiltration, new techniques such as continuous venovenous hemofiltra tion, hemodiafiltration, and high flux dialysis have been developed an d clinically used. A parallel improvement in efficiency has been achie ved with urea daily clearances as high as 50 L or more, The use of spe cial highly permeable dialyzers has also permitted an increase in the clearances of larger solutes, thus leading to significant removals of chemical substances involved in acute inflammation and sepsis, In this field, recent observations have suggested using hemofiltration with h igh volumes of fluid exchange, The hardware and software of the newer CRRT systems are key in achieving these results and in safely performi ng such challenging techniques. (C) 1997 by the National Kidney Founda tion, Inc.