Cotera A, Lorca E, Saffie A, Sepúlveda M
Unidad Nefrología Intensiva, Hospital Clínico de la Universidad de Chile.
Rev Med Chil. 1992 Dec;120(12):1388-92.
Continuous hemodialysis is advantageous for the treatment of renal failure in critically ill patients. This study reports our experience in the treatment of emergencies during chronic renal failure with continuous hemodialysis using a Cuprofane membrane. Eighteen patients with acute decompensations of chronic renal failure were treated with continuous hemodialysis (14 arteriovenous and 4 veno-venous). Procedures lasted a mean of 44.2 h, blood urea nitrogen decreased from 150.3 +/- 49.8 to 60.6 +/- 30.7 mg/dl, metabolic acidosis was corrected raising serum bicarbonate from 10.1 +/- 44 to 17.8 +/- 3.3 mEq/L and hyperkalemia was corrected. Mean ultrafiltration was 239.6 +/- 124.6 ml/h which allowed to withdraw a mean 10.590 ml of ultrafiltrate. Two patients were complicated with femoral artery pseudoaneurysms and one patient with a catheter related sepsis. Global mortality was 16.7%, which compared favorably with the 32.1% predicted mortality according to the Simplified Acute Physiology Score. It is concluded that continuous hemodialysis, a readily available procedure, is suitable for the treatment of emergencies during chronic renal failure.
连续性血液透析对于危重症患者肾衰竭的治疗具有优势。本研究报告了我们使用铜仿膜进行连续性血液透析治疗慢性肾衰竭急症的经验。18例慢性肾衰竭急性失代偿患者接受了连续性血液透析治疗（14例动静脉通路，4例静脉-静脉通路）。治疗过程平均持续44.2小时，血尿素氮从150.3±49.8降至60.6±30.7mg/dl，代谢性酸中毒得到纠正，血清碳酸氢盐从10.1±4.4升至17.8±3.3mEq/L，高钾血症也得到纠正。平均超滤量为239.6±124.6ml/h，平均超滤出10590ml。2例患者并发股动脉假性动脉瘤，1例患者发生导管相关败血症。总体死亡率为16.7%，与根据简化急性生理学评分预测的32.1%死亡率相比更优。结论是，连续性血液透析是一种易于实施的治疗方法，适用于慢性肾衰竭急症的治疗。
