Continuous Venovenous Hemofiltration Clinical Trial
Official title:
Evaluation of Sublingual Microcirculation by Means of SDF Imaging by Stepwise Ultrafiltration in CVVH Patients on the ICU
In patients where fluid is withdrawn from the bloodstream by Continuous Venovenous Hemofiltration (CVVH), the ultrafiltration rate will be calculated for a zero balance. From there, the ultrafiltration steps are performed, after increasing the ultrafiltration rate, the sublingual microcirculation is assessed by sidestream dark field (SDF). The images are subsequently randomly analyzed, and the sublingual microcirculation is expressed as a number, the microvascular flow index (MFI).
Before deciding to threat a patient actively with CVVH, a target balance will be agreed for
the next 12 hours. Then the ultrafiltration rate for the zero balance is calculated. From
there, the ultrafiltration rate progressively increased to 50 ml per hour, up to a maximum
ultrafiltration rate of 300 ml per hour.
After each increase of the ultrafiltration rate, the sublingual microcirculation is assessed
by SDF.
After obtaining the desired ultrafiltration rate, the microcirculation will again be
assessed before and after the patient is temporarily placed in Trendelenburg position. This
could possibly show that underfill has the greatest influence on the microcirculation, and
not other factors like a rising hematocrit.
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Observational Model: Cohort, Time Perspective: Prospective