Conventional membranes used for CRRT have a limited middle molecule clearance. New membranes called super high-flux (SHF) or high cutoff membranes have been investigated. The loss of albumin with hemofiltration is a major drawback, but these membranes can be used in CVVHD with regional citrate anticoagulation (Ci-Ca® CVVHD), which may limit albumin loss, and contribute to a prolonged filter patency and an improved and stable middle molecule clearance. We evaluated saturation coefficients (SC), plasma clearances (PCL) and serum levels of eight small and middle molecules during 72 hours of Ci-Ca® CVVHD with a SHF membrane (Ultraflux®EMiC®2).
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Siebeck et al. (2015) studied this question.