THE THERAPY OF MULTIPLE ORGAN FAILURE WIT H CONTINUOUS VENOVENOUS HIGH-VOLUME HEMOFILTRATION - PRINCIPLE AND APPLICATION

Between 1987 and 1994 in 24 patients suffering from multiple organ fai lure the new method of continuous high-volume veno-venous hemofiltrati on (HVCVVH) was performed. Compared with the usual methods of dialysis and hemofiltration the HVCVVH has proven two advantages: at first, it was possible to obtain a high blood flow through the filter powered b y a pump. Secondly the fluid withdrawal from the intracardiac body reg ion and the controlled infusion of fluid into the supracardiac veins w as possible without decreasing the cardiac preload in patients with se vere disorders of volume distribution. 18 of 24 treated patients had a stable circulation without need of catecholamines after the filtratio n. In 14 of the 24 patients the FiO(2) was reduced to 0.3 and decrease d during filtration. 13 patients survived the observation time of 30 d ays, 2 patients died during the procedure of filtration.