|
|
|
|
|
| Comparing the benefits of CVVH with various replacement solution volume in chronic renal failure patients with lactic acidosis |
| Xu Zhi-hui, Li Yu-ying, Li Fang |
| Graduate School, Heilongjiang University of Chinese Medicine, Harbin 150040, China |
|
|
|
|
Abstract Objective The study aimed to assess the results from two cures of using different volume sizes which are high-volume (HV) and standard-volume (SV) of continuous venovenous hemofiltration (CVVH) for chronic renal failure (CRF) patients with lactic acidosis (LA).Methods Adopting the method of prospective randomized control, 24 of CRF with LA cases from nephrology department of the 211 Hospital of the People′s Liberation Army from July 2016 to June 2017 were picked and moreover divided into the two groups mentioned above based on the random number table method. On the basis of conventional comprehensive treatment, the two groups of cases were cured for 48 h continuously with 35 mL/（kg·h） (SV) and 65 mL/（kg·h） (HV), respectively. The variation of arterial blood gas pH before, 24 h after-and 48 h after-curation, the concentration of serum lactate of the two groups and death cases in 14 days were monitored and compared.Results Before the treatment, the two groups had comparability in pH value and concentration of serum lactate in which there were no significant differences. After the treatment, pH value and concentration of serum lactate in two groups were significantly improved(P=0.00).After 24h-treatment, the changes of pH value and concentration of serum lactate were not obvious (tpH=0.463；PpH=0.504；t乳酸=0.249；P乳酸=0.623); after 48 h-treatment, the changes of concentration of serum lactate in the two groups were prominent (t组间=4.881，P组间=0.038). Conclusion Both HV-CVVH and SV-CVVH are effective for eliminating the lactate in CRF patients with lactic acidosis and rectifying acid-hase disturbance. However, there are no significant differences between them in clinical benefits and reducing mortality (P>0.05). This provides the reasonable CVVH therapeutic scheme for the chornic real failure with lactic acidosis.
|
|
|
|
Corresponding Authors:
Li Fang, E-mail: lifang630927@163.com
|
|
|
|
| ［1］Reddy AJ, Lam SW, Bauer SR, et al. Lactic acidosis:Clinical implicationsand management strategies ［J］. Cleve Clin J Med, 2015, 82(9): 615-624.
［2］Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for theEvaluation and Management of Chronic Kidney Disease［J］. Kidney Inter, 2013， 3（Suppl）: 1-150.
［3］Jeffrey AK, Nicolaos EM. Lactic Acidosis［J］. N Eng J Med, 2014, 371(24): 2309-2319.
［4］王海燕. 肾脏病学［M］. 第3版. 北京: 人民卫生出版社, 2008: 384-387.
［5］Seheult J, Fitzpatrick G, Boran G. Lactic acidosis: an update［J］. Clin Chem Lab Med, 2017, 55（3）:322-333..
［6］Oudemans-van Straaten HM, Elbers PW. How to explain and exploit the beneficialeffects of high-volume hemofiltration on hemodynamics and strong ion gap［J］. Intensive Care Med, 2013, 39（6）: 1140-1142.
［7］王质刚. 血液净化新概念: 血液净化理论与技术的新进展［J］. 中国血液净化, 2008, 7（2）: 59-60.
［8］Honore PM, Joannes-Boyau O, Boer W, et al. High-volume hemofiltration in sepsis and SIRS: current concepts and future prospects［J］.Blood Purif, 2009, 28 (1) : 1-11.
［9］李盘石. 高容量血液滤过对严重乳酸酸中毒患者的救治［J］. 临床医学工程, 2015, 22(6): 691-692.
［10］林书生，高勃，姜平，等. ICU危重患者血乳酸变化水平与预后的关系探讨［J］. 临床急诊杂志, 2013, 14(1): 20-23，26. |
|
|
|
Address: 1 North 2nd Street,
Zhongguancun, 
