Sahutoglu Tuncay, Sahutoglu Elif
1 Nephrology Unit, Şanlıurfa Mehmet Akif Inan Education and Research Hospital, Şanlıurfa, Turkey.
2 Pulmonary Medicine, Sanliurfa Education and Research Hospital, Şanlıurfa, Turkey.
Int J Artif Organs. 2018 Aug;41(8):431-436. doi: 10.1177/0391398818784275. Epub 2018 Jul 5.
BACKGROUND/AIMS: Severe metabolic acidosis during cardiopulmonary resuscitation is an important and yet unresolved issue. The potential use of hemodialysis for severe metabolic acidosis during cardiopulmonary resuscitation was investigated.
Acute hemodialyses between January 2012 and April 2017 were reviewed for patients with concomitant hemodialysis and cardiopulmonary resuscitation. In addition, MEDLINE was searched for similar reports. Data were extracted from hospital records.
Two patients (36M, 70F) were found to study, without similar reports in MEDLINE. Cardiac arrests (in-hospital) occurred due to severe metabolic acidosis in both patients (due to ethylene glycol and metformin intoxications, respectively). Return of spontaneous circulation could not be obtained within the first 28 and 30 min of cardiopulmonary resuscitation only, whereas both patients had return of spontaneous circulation following at least 45 min of concomitant hemodialysis and cardiopulmonary resuscitation. One patient (70F) was discharged with good neurological outcome, but the other died.
The addition of high-efficiency hemodialysis during cardiopulmonary resuscitation may contribute to the return of spontaneous circulation in patients with severe metabolic acidosis due to intoxication.
背景/目的：心肺复苏期间的严重代谢性酸中毒是一个重要但尚未解决的问题。本研究探讨了血液透析在心肺复苏期间治疗严重代谢性酸中毒的潜在应用。
回顾了2012年1月至2017年4月期间接受血液透析并同时进行心肺复苏患者的急性血液透析情况。此外，检索MEDLINE以查找类似报告。数据从医院记录中提取。
发现两名患者（36岁男性，70岁女性）可供研究，MEDLINE中无类似报告。两名患者均因严重代谢性酸中毒导致心脏骤停（均在医院内）（分别因乙二醇和二甲双胍中毒）。仅在心肺复苏的前28分钟和30分钟内未恢复自主循环，而两名患者在至少45分钟的血液透析与心肺复苏同时进行后均恢复了自主循环。一名患者（70岁女性）出院时神经功能良好，但另一名患者死亡。
在心肺复苏期间加用高效血液透析可能有助于因中毒导致严重代谢性酸中毒患者恢复自主循环。
