Continuous veno-venous hemofiltration and intermittent hemofiltration in treatment of type 1 cardiorenal syndrome: a clinical research

Abstract

Objective To compare the effects of continuous veno-venous hemofiltration(CVVH)and intermittent hemofiltration(IHF) on the hemodynamics and clinical outcomes of patients with type 1 cardiorenal syndrome.Methods From May 2008 to June 2011,34 patients diagnosed with type 1 cardiorenal syndrome were admitted to our hospital and received CVVH(19 cases) or IHF(15 cases).The general data,acute hemodynamic changes before and after hemofiltration and clinical outcomes at 28 days after hemofiltration were evaluated.Results There were no significant differences in the heart rates,diastolic blood pressure between the two groups before and after hemofiltration(P0.05).The systolic pressure was similar between the two groups before hemofiltration(P0.05),but that in the IHF group was significantly lower than that in the CVVH group after hemofiltration(P0.05).No significant difference was found in the maximal mean pressure or blood pressure changes between the two groups at 48 h after hemofiltration(P0.05),but the minimal mean pressure in IHF group was significantly lower than that in the CVVH group(P0.05).The improvement of cardiac function and the mortality rates at 28 d after hemofiltration were not significantly different between the two groups(P0.05).Multivariate analysis suggested that APACHE Ⅱ was the main influence factor of 28-day mortality of patients,and APACHE Ⅱ and net ultrafiltration were the main influence factor of the minimal mean pressure.Conclusion Compared with IHF,CVVH fails to greatly reduce the mortality of patients with type 1 cardiorenal syndrome.The severity of the disease is the main influence factor for the hemodynamic changes and the 28-day mortality of patients with type 1 cardiorenal syndrome.