VASCULAR COMPLICATIONS OF CONTINUOUS ARTERIOVENOUS HEMOFILTRATION IN TRAUMA PATIENTS

Continuous arteriovenous hemofiltration (CAVH) has recently become use ful in the treatment of acute renal failure following trauma. It allow s continuous volume removal and avoids the acute hemodynamic changes o ften seen with hemodialysis. To determine the risks of CAVH catheters, the records of trauma patients undergoing CAVH from August 1989 throu gh May 1992 were reviewed. Of 4685 trauma patients, 29 developed renal failure requiring dialysis, with 26 managed with CAVH. Vascular acces s was obtained via 126 percutaneous 8F femoral arterial and venous cat heters (64 arterial, 62 venous) and four Scribner shunts. There was a total of 309 CAVH-D days, with an average of 11.9 days per patient. Co mplications included one femoral arteriovenous fistula, one pseudoaneu rysm, and one deep venous thrombosis, resulting in a 3.1% (2 of 64) ar terial complication rate and a 1.6% (1 of 62) venous complication rate . The incidence of arterial complications compares with that of angiog raphy, but complications were major and required surgery. Alternative techniques such as continuous venovenous hemofiltration may prove bene ficial.