Karnina Resiana, Irawany Vera, Manggala Sidharta Kusuma, Aulya Justika Usmadhani, Faruk Muhammad
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia.
Pan Afr Med J. 2024 Oct 9;49:30. doi: 10.11604/pamj.2024.49.30.45195. eCollection 2024.
Acute heart failure is associated with high hospitalization and mortality rates. A strong, independent risk factor for mortality in patients with heart failure is acute kidney injury, and the condition caused by this connection between disturbances in heart function and proper kidney functioning is cardiorenal syndrome (CRS). This case report discusses the role of continuous renal replacement therapy (CRRT) in the management of a CRS case with septic shock due to pneumonia. A 56-year-old female patient with a history of acute heart failure developed complications of acute kidney dysfunction and was diagnosed with CRS type 1. Standard management was conducted in the intensive cardiac care unit, but the condition of the patient worsened. The patient was admitted to the intensive care unit and underwent CRRT, after which the kidney function and hemodynamic performance of the patient improved. Therefore, the use of CRRT can be a therapeutic option for CRS patients. CRRT acts as an ultrafiltration mechanism that removes circulating cytokines from the blood, reduces volume overload, and addresses electrolyte imbalance, thus enhancing the functioning of the heart and kidneys and potentially improving prognoses.
急性心力衰竭与高住院率和死亡率相关。急性肾损伤是心力衰竭患者死亡的一个强大的独立危险因素,而由心功能紊乱与肾脏正常功能之间的这种关联所导致的病症就是心肾综合征(CRS)。本病例报告讨论了连续性肾脏替代疗法(CRRT)在一名因肺炎导致感染性休克的CRS病例管理中的作用。一名有急性心力衰竭病史的56岁女性患者出现了急性肾功能不全并发症,并被诊断为1型CRS。在心脏重症监护病房进行了标准治疗,但患者病情恶化。患者被收入重症监护病房并接受了CRRT,此后患者的肾功能和血流动力学表现得到改善。因此,使用CRRT可以作为CRS患者的一种治疗选择。CRRT作为一种超滤机制,可从血液中清除循环细胞因子,减少容量超负荷,并解决电解质失衡问题,从而增强心脏和肾脏的功能,并有可能改善预后。