Figure 322

Fluid replacement in hemofiltration. Because hemofiltration achieves substantial solute clearance by removing large volumes of plasma water (which contains the dissolved solutes), the removed fluid must be replaced. The replacement fluid can be infused into the extracorporeal circuit before the blood enters the filter (predilution, or replacement before expenditure) or after the blood leaves the filter (postdilution). More replacement fluid is required when it is given before filtration rather than after to provide equivalent solute clearance because the plasma in the filter (and therefore the ultrafiltrate) is diluted in the predilution mode.

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