关键词: 乳酸置换液, 连续性肾脏替代治疗, 危重

Abstract: 【Abstract】 Objective to investigate the value of lactate substitution fluid for continuous renal replacement therapy (CRRT) in critical ill patient. Methods sixty-three patients without severe hepatic failure and chronic renal failure in intensive care unit were treated with CRRT, thirty-four patient using lactate containing fluids but twenty-nine using bicarbonate-based fluids. Lactate, PH, base-exess, HCO3-, mean arterial pressure(MAP) were measured before, after 24h and 48h CVVH. Result The plasma lactate concentration was no statistically decreased after 24h and 48h CVVH in lactate group.Lactate was remarkably decreased after 24h and 48h CVVH in bicarbonate group（P＜0.05）.PH, base-excess and HCO3- were improved in both group.Serum creatinine fell significantly in both group after 24h CVVH, even greater afte 48h CVVH. However ,there were no significant difference in mean arterial pressure and serum sodium during CVVH. Lactate and base-excess but not other parameters were greaterly changed in lactate group compared with bicarbonate group.Conclsion Lactate substitution fluid can maintain acid-base balance, pressure and homeostasis but not elevated lactate level .It can be safely used for CVVH in critical ill patients.

Key words: Lactate substitution fluid, Continuous renal replacement therapy, Critical ill