| [ Summary ] |
Continuous renal replacement therapy (CRRT) has been widely accepted over the last decade in the critically ill patients. There are several well established advantages to CRRT, such as hemodynamic stability and optimal fluid balance and others. Continuous arterio-venous hemofiltration (CAVHF) without blood pump is a simple method, however it has been some complications resulted from arterial access. Therefore a veno-venous pump driven technique (CVVHF or CHF) has been developed through improvement of vascular catheter procedure with blood pump and monitoring system for extracorporeal circulation. These hemofilters have a lower priming volume, highly permeable to solute and water, highly adsorbent capacities, longer operating times and biocompatible membranes. Another way continuous hemodiafiltration (CHDF) which has combined the convective diffusive principle was deve1oped, because CHF has limit in small molecules solute clearance by convective transport. Recently, automatic fluid balance technique was improved by newest generation machines with micro-computer assisted devices such as the ACH-10 (Asahi), the TR-520 (Toray), the KM-8600(Kurare)and the JUN-600(Ube Medical). In future, new membrane technology, on-line preparation technique for sterile pyrogen free dialysate and replacement fluid, and new generation equipment might be developed. |