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Venovenous hemofiltration was performed twice for two patients and once for four patients because of volume overload.
In terms of volume control, patients were either ultrafiltrated because of volume overload in lung failure in the first 24 hours (four patients, -645 to −3,345 ml/24 hours) or received volume replacement as part of hypertensive shock therapy (six patients, 180 to 2,945 ml/24 hours).
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In adults, units of PRBCs and other components can be split or centrifuged to allow excess plasma to be extracted manually to reduce the volume infused to patients at risk of volume overload because of severe congestive heart failure or cardiomyopathy.
The main technical challenges include: (1) working with very small aliquots of blood components because of the inherently greater risk of volume overload and (2) the fact that risk of infection, product preservatives, and product storage breakdown can have an even greater effect in the pediatric population due to their unique physiology and biology.
However, because this patient group is still at high risk of volume overload (pulmonary oedema) and cardiovascular mortality [ 25, 26], investigation of the BNP value may also be important in patients with CKD in the ICU setting.
Consequences of volume overload.
The adverse consequences of volume overload and a high CVP are summarized listed below.
In case of volume overload, the mainstay of patient management is water restriction and loop diuretics.
In addition, a continuous regulation of body fluid avoids periods of volume overload and depletion.
ESRD represents a combination of volume overload (fluid retention, the presence of arteriovenous shunt, anemia, etc).
However, the ECW/TBW ratio may not be an ideal measurement of volume overload.
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