Influence of continuous haemofiltration-related hypothermia on haemodynamic variables and gas exchange in septic patients

To investigate the influence of continuous haemofiltration (CHF) on haemodynamics, gas exchange and core temperature in critically ill septic patients with acute renal failure. In 20 patients (17 male, 3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic variables were mea...

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Published in:Intensive care medicine 1994-07, Vol.20 (6), p.431-436
Main Authors: MATAMIS, D, TSAGOURIAS, M, KOLETSOS, K, RIGGOS, D, MAVROMATIDIS, K, SOMBOLOS, K, BURSZTEIN, S
Format: Article
Language:English
Subjects:
Acute Kidney Injury - etiology
Acute Kidney Injury - physiopathology
Acute Kidney Injury - therapy
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Body Temperature
Critical Illness
Emergency and intensive care: infection, septic shock
Female
Hemodynamics
Hemofiltration - adverse effects
Humans
Hypothermia - etiology
Hypothermia - physiopathology
Intensive care medicine
Male
Medical sciences
Middle Aged
Pulmonary Gas Exchange
Shock, Septic - complications
Shock, Septic - physiopathology
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Summary:To investigate the influence of continuous haemofiltration (CHF) on haemodynamics, gas exchange and core temperature in critically ill septic patients with acute renal failure. In 20 patients (17 male, 3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic variables were measured at regular intervals during the first 48 h of haemofiltration. Baseline data were compared to those obtained 30 min after initiating CHF and also to those during hypothermia (if observed). Haemodynamic variables remained remarkably constant throughout the study period. In patients with a relatively low ultrafiltration rate (855 +/- 278 ml/h) temperature did not change, while in patients with a high ultrafiltration rate (1468 +/- 293 ml/h) core temperature significantly decreased from 37.6 +/- 0.9 degrees C to 34.8 +/- 0.8 degrees C (p < 0.001). There was a statistically significant correlation between temperature decrease and ultrafiltration rate (r = -0.68, Y = 1.8-0.003 X, p < 0.01). Hypothermic patients also showed a mean decrease in VO2 from 141 +/- 22 ml/min/m2 to 112 +/- 22 ml/min/m2 (p < 0.01) with a concomitant increase in PaO2 from 103 +/- 37 mmHg to 140 +/- 42 mmHg (p < 0.001) and in PvO2 from 35 +/- 4 mmHg to 41 +/- 5 mmHg (p < 0.001). 1) Continuous haemofiltration does not cause significant alternations in haemodynamic variables. 2) Hypothermia frequently occurs in patients undergoing continuous haemofiltration with high ultrafiltration rates. These hypothermic patients show a reduction in VO2 leading to an increase in PvO2 and PaO2. This mild hypothermia in these circumstances has no evident deleterious effects.
ISSN:0342-4642
1432-1238
DOI:10.1007/BF01710654