Abstract
Continuous hemofiltration is usually regarded as a safe method for controlling fluid overload in neonates presenting acute renal failure. We considered that continuous hemodiafiltration with a hemofilter type especially designed for use in the neonatal period could improve urea removal as compared with hemofiltration. Continuous arteriovenous hemofiltration (CAVH) and hemodiafiltration (CAVHD) were consecutively performed on 7 anesthetized adult rabbits which were given an urea infusion. The hemofilter was a 800-cm2 polysulfone model (Amicon Minifilter Plus). Mean values for physiological and operational parameters were comparable during CAVH and CAVHD, i.e., mean blood pressure (69.6 ± 14.9 and 70 ± 13.1 mm Hg, respectively), arterial oncotic pressure (16.0 ± 2.4 and 16.0 ± 1.7 mm Hg), hematocrit (36.2 ± 5.8 and 36.7 ± 4.4%), protein plasma level (38.9 ± 7.0 and 39.0 ± 6.4 g/l), urea plasma level (20.6 ± 6.5 and 19.9 ± 7.0 mmol/l), plasma flow in the hemofilter (7.89 ± 8.48 and 7.12 ± 3.08 ml/min), and ultrafiltrate rate (1.17 ± 0.49 and 1.73 ± 0.78 ml/min). CAVHD allowed a significant increase in urea clearance (4.74 ± 4.51 ml/min) as compared with CAVH (1.23 ± 0.81 ml/min). These experimental results suggest that CAVHD usefulness should be assessed in neonates presenting acute renal failure.