Effect of haemofiltration on pathological fibrinolysis due to severe sepsis: a case report

Bleeding due to coagulopathy is a frequent complication of severe sepsis, e specially in burn patients. The primary treatment is aimed at the underlyin g cause but additional supportive measures, consisting mainly of coagulatio n factor replacement, are frequently necessary. We describe the salutary ef fect of continuous veno-venous haemofiltration (CVVH) with predilution on d iffuse haemorrhage in a patient with severe septic shock and renal failure. The diffuse haemorrhage was initially treated with replacement of coagulat ion factors. Prothrombin time and partial thromboplastin time became normal while diffuse bleeding continued and the thrombelastogram showed evidence of fibrinolysis. A short period of CVVH lead to the cessation of bleeding w hich was reflected by a normal thrombelastogram. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.