Tuesday November 22, 2005
Early CRRT in septic shock
A recent observational study of 60 patients from france is published in ccforum (november, 2005) regarding early initiation of continuous veno-venous haemodiafiltration (CVVHDF), in patients meeting at the same time criteria for sepsis, refractory circulatory failure, acute renal injury, and acute lung injury. CVVHDF was started after 6–12 hours of full haemodynamic support. There are 3 interesting conclusions:
1. In patients showing improvement in metabolic acidosis after 12 hours of CVVHDF, with progressive improvement in organ failures; the final mortality rate was 30%.
2. Those patients who did not show any improvement in metabolic acidosis, mortality rate was 100%.
3. The crude mortality rate for the whole group (53%), was significantly lower than the predicted mortality using Simplified Acute Physiology Score II (79%).
References: click to get abstract/article
1. Early veno-venous haemodiafiltration for sepsis-related multiple organ failure - Critical Care 2005, 9:R755-R763
2. New Simplified Acute Physiology Score - from sfar.org site