In this reflection, CVVH was claimed by some healthcare workers to be a futile treatment because the patient's condition had not improved but deteriorated with the development of heparin-induced thrombocytopenia and frequent clotting of the circuit induced deterioration of her anaemic state.
When analysing this case, it is suggested that CVVH should not be considered to be a futile treatment.
2001; Bauer, 2005) also indicate that heparin-induced thrombocytopenia can be managed by replacing heparin with citrate, as citrate is an effective anticoagulant in CVVH therapy.
The predicted mortality of this patient was already high due to her sepsis, and it cannot be concluded that her death was due solely to the withdrawal of CVVH.
As in this case, some nursing staff labelled CVVH as a futile treatment to the patient and may have been using this as an excuse to avoid taking care of this particular patient.
If the patient treatment plan in this case study had been approached collaboratively, the CVVH treatment goal would have been determined between both medical and nursing staff, and it is possible that a different conclusion may have been reached.
Plasma lactate levels increased progressively to more than three times in the peritonitis group and were significantly higher than that in the peritonitis plus CVVH group.
However, the activity of complex I was better maintained in animals receiving CVVH.
However, plasma nitrite/nitrate increased in peritonitis group, but was nearly normal in animals receiving CVVH at 13 h after peritonitis induction (Figure 5).
The major finding of this study is that high-volume CVVH improves myocardial mitochondrial respiratory-chain complexes activity, such as higher activity of respiratory chain complex I in peritonitis-induced septic shock.
Our findings suggest that high-volume CVVH could be such an adjuvant therapy.
As an effective adjuvant treatment method, CVVH has been widely used in clinical patients.