The use of peripheral ultrafiltration for deresuscitation in the critically ill

Patients were recruited if they were fluid overloaded and a clinician intention to target a negative fluid balance, with a standard multi-lumen central venous catheter in situ. Ultrafiltration was guided by the fluid balance targets set by the treating intensivist. Criteria for feasibility included daily fluid balance within 500ml of a pre-defined clinician target.<br><br>Results <br>Ex-vivo assessment demonstrated that a standard central venous catheter and a peripheral venous catheter allowed adequate flow rates. 18 patients were recruited to the feasibility study and 17 underwent the intervention.

The primary outcome of fluid balance within 500mL of target was met on 20 (55.6%) of deresuscitation days. The mean (standard deviation) circuit lifespan was 16.8 (14.7) hours. <br><br>Conclusions<br> This thesis provided evidence for the technical feasibility and safety of low flow ultrafiltration to treat fluid overload using standard central and peripheral venous access. However, circuit loss was common, resulting in variable duration of therapy, limiting widespread application of the technique.

While low flow ultrafiltration may be a suitable alternative to the use of diuretics in selected patients, future research should focus on strategies to improve circuit lifespan.