Continuous arteriovenous hemofiltration.

Abstract

CAVH is a bedside form of dialysis that is used in the treatment of fluid and electrolyte disorders seen in critically ill patients. The major advantages of the procedure include (1) gradual, continuous therapy, which is ideal in hemodynamically unstable patients; (2) control of fluid balance; and (3) ease of administration in the ICU. The major disadvantages of CAVH include (1) a requirement for arterial access, (2) the need for anticoagulation, (3) the risks of infection from long-term indwelling vascular lines, and (4) the potential for significant volume depletion. The effectiveness of CAVH may continue to improve owing to technical developments in filter composition and the application of clinical tactics such as suction-assisted filtration, predilution fluid replacement, or regional heparinization. The next step in bedside dialysis is represented by CAVHD, which offers all of the advantages of CAVH as well as improved urea clearance.