Abstract
Hemofilters with different membranes and surface areas which utilize the spontaneous circulation of the blood were used to resolve fluid overload in uremic and nonuremic patients and to correct uremia in patients whose clinical conditions did not allow effective application of the usual depuration methods. Amicon D 20 and Amicon D 30 hemofilters were both effective. We improved their performance by applying a slight negative pressure on the ultrafiltrate line. The relevant hemodynamic and blood chemistry parameters were determined in all the patients to evaluate vascular stability and depuration effectiveness. In addition, a portable system was tried in one case, which allowed the patient complete mobility. Our results indicate that continuous arteriovenous hemofiltration, when vascular access consists of a Quinton-Scribner shunt, is a simple and effective method for the treatment of fluid overload resistant to pharmacologic therapy and to treat uremia in patients for whom the traditional methods of extracorporeal depuration are contraindicated.