Early Continuous Renal Replacement in the Postoperative Period after Cardiovascular Surgery

Abstract

Introduction: Continuous renal replacement therapy is a novel procedure applied for the management of acute renal failure in the critically-ill patient, as well as in cases of systemic inflammatory response syndrome. It is preferably applied in those patients with hemodynamic deterioration for whom intermittent dialytic treatment can be detrimental due to the relative quickness at which replacement occurs. However, there is no consensus on its early use.

Objective: To present the case of a critical patient who received early continuous renal replacement therapy.

Case presentation: A 48-year-old female patient, with a history of grade-5 chronic kidney disease, on an intermittent hemodialysis regimen, with arterial hypertension and obesity, was admitted to the cardiovascular intensive care unit of Hospital "Hermanos Ameijeiras" in the immediate postoperative period with complications following aortic valve replacement surgery, in which early continuous renal replacement therapy proved to be efficient for the treatment of acute chronic renal failure, since it allowed maintaining good control of the hemodynamics of the internal environment and volemia.

Conclusions: The shown experience provides elements in favor of the safety of this treatment, which makes it recommendable in the severe post–cardiovascular surgery patient, as part of the therapeutic arsenal to be used.