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Chinese Journal of Blood Purification ›› 2005, Vol. 4 ›› Issue (8) : 447-450.

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Abstract

Objective To study the optimal composition of the substitution fluid in high volume hemofiltration (HVHF). Methods Thirty-seven patients with MODS received 171 HVHF treatments. Blood samples were collected from the patients, biochemical parameters and hemodynamic parameters were tested before and after the treatment. Those parameters were also monitored during the whole session of each treatment. Our substitution contained 2500ml of saline, 1000ml of distilled water, 10ml (50%) of glucose solution, 250ml (5%) of NaHCO3, 12ml (10%) of KCl,40ml(10%) of calcium gluconate and 3ml (25%) of MgSO4. The fluids were administered by pre-dilution mode and low molecular weight heparin (LMWH) was available for anticoagulation. Results During each session of HVHF, patients?hemodynamic parameters such as heart rate (HR), mean artery pressure (MAP) and central veneus pressure (CVP) were steady. There were no significant changes of serum ALT, AST, albumin, globulin, glucose and electrolytes level after one session. Blood -gas analysis showed that under the treatment, patients?arterial pH, PCO2 and HCO3 were maintained in the normal range, while PO2 and base excess (BE) had got marked improvement. There had been a significant improvement on patients?hepatic function and renal function after the treatments with the reduction of serum TB, CB and creatinine.Conclusions Our prescription for the substitution fluid is easy to make. With the precise calculation of the ionic concentration, the substitution fluids made by ourselves can be applied safely for HVHF treatments.