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急诊肝再次移植期间的持续动静脉血液透析:两例病例报告

Continuous arteriovenous haemodialysis during emergency hepatic retransplantation: two case reports.

作者信息

Salord F, Bailly M P, Gaussorgues P, Workineh S, Pouyet M, Robert D

机构信息

Service de réanimation médicale et assistance respiratoire, Hôpital de la Croix-Rousse, Lyon, France.

出版信息

Intensive Care Med. 1990;16(5):330-1. doi: 10.1007/BF01706360.

Abstract

Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) device, without pump. Vascular access was obtained with femoral catheters. Such a continuous dialysis and ultrafiltration allowed us to infuse massive amounts of blood products before and during surgery and to maintain pH, potassium and lactate at levels compatible with survival in anuric patients. Standard haemodialysis replaced CAVHD when haemodynamic stability was restored.

摘要

两名患有严重肝肾功能衰竭的患者接受了急诊肝脏再次移植手术(移植后第2天和第6天)。术前开始进行持续动静脉血液透析,并在使用无泵的生物滤过器(SCU/CAVH AN 69 S)进行再次移植手术期间成功实施,未发生任何意外。通过股静脉导管建立血管通路。这种持续透析和超滤使我们能够在手术前和手术期间输注大量血液制品,并将pH值、钾和乳酸维持在与无尿患者生存相适应的水平。当血流动力学恢复稳定后,标准血液透析取代了持续动静脉血液透析。

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