[Lactate kinetics during constant hemodiafiltration in critically severe patients with the systemic inflammatory response syndrome and multiple organ failure].

High-volume hemodiafiltration is a new approach to the treatment of critical patients with generalized inflammatory reaction and multiple organ failure. Increase of the liquid exchange during the procedure is fraught with the development of secondary metabolic disorders in cases when lactate-based buffer is used (with high amounts of lactate). This study was undertaken to evaluate the consequences for the acid-base balance in patients with hypoxia and circulatory failure. Twelve patients (6 men and 6 women) with APACHE II score 25 were examined. The major treatment modality was continuous hemodiafiltration. The results indicate that lactate-buffered solutions can be used in critical patients, because they do not cause a notable increase in the blood lactate levels due to its good utilization. Moreover, it is associated with correction of disorders in acid-base balance. No negative clinical consequences were observed after using lactate anion in high concentrations as the major buffer compound.