Fang J T, Chen Y C, Tien Y C, Huang C C
Department of Medicine, Chang Gung Memorial Hospital, Taipei, Chang Gung University, Taoyuan, Taiwan, ROC.
Changgeng Yi Xue Za Zhi. 1998 Jun;21(2):146-51.
Continuous renal replacement therapies have become the preferable methods for treating critically ill patients with acute renal failure. We studied the use of continuous venovenous hemodialysis (CVVHD) for the management of multiple organ failure patients with acute renal failure.
Forty patients in intensive care units were studied. Their mean age was 50.5 (range 21 to 82) years. The mean of number of organ system failures per patient was 4.9 (range 4 to 6). All patients required mechanical ventilation. CVVHD was performed from the femoral vein via a double-lumen catheter. Blood flow was maintained via blood pump at rate of 120 to 150 ml/min. Bicarbonate solution was delivered to the dialysate ports of the filter at rate of 700 to 900 ml/hour. Any complications during therapy were recorded.
The mean urea clearance was 14.7 ml/min and the mean creatinine clearance was 15.4 ml/min. Electrolytes were all within the normal ranges. There were two episodes of extracorporeal circuit blood clotting and one patient experienced hypothermia. Seven of the 40 patients (17.5%) survived.
CVVHD is a safe, effective, easily established therapy for managing the multiple organ failure patients with acute renal failure, offering good metabolic, electrolyte, and fluid control.
连续性肾脏替代治疗已成为治疗急性肾衰竭危重症患者的首选方法。我们研究了连续性静脉-静脉血液透析（CVVHD）在治疗合并急性肾衰竭的多器官功能衰竭患者中的应用。
对重症监护病房的40例患者进行了研究。他们的平均年龄为50.5岁（范围21至82岁）。每位患者器官系统衰竭的平均数量为4.9个（范围4至6个）。所有患者均需要机械通气。通过双腔导管从股静脉进行CVVHD。通过血泵将血流量维持在120至150毫升/分钟的速率。以700至900毫升/小时的速率将碳酸氢盐溶液输送至滤器的透析液端口。记录治疗期间的任何并发症。
平均尿素清除率为14.7毫升/分钟，平均肌酐清除率为15.4毫升/分钟。电解质均在正常范围内。发生了两例体外循环凝血事件，一名患者出现体温过低。40例患者中有7例（17.5%）存活。
CVVHD是一种安全、有效且易于建立的治疗方法，可用于治疗合并急性肾衰竭的多器官功能衰竭患者，能实现良好的代谢、电解质和液体控制。
