Gr. Nimmo et al., ACID-BASE RESPONSES TO HIGH-VOLUME HEMOFILTRATION IN THE CRITICALLY ILL, Nephrology, dialysis, transplantation, 8(9), 1993, pp. 854-857
We have studied the acid-base and cardiorespiratory effects of intermi
ttent pumped high-volume venovenous haemofiltration (HVHF) using repla
cement fluid containing lactate as the source of bicarbonate in critic
ally ill patients. We demonstrated significant hyperlactataemia throug
hout the procedure, but there was no deterioration in acid-base status
, haemodynamics, or oxygen delivery. These observations suggest that t
he worsening of acidosis and the hypotension that have been described
with this technique [1] can be avoided by appropriate monitoring and r
esuscitation prior to haemofiltration, and may be due to unrecognized
inadequacies in the oxygen transport system.