PDF(415 KB)

Chinese Journal of Blood Purification ›› 2007, Vol. 6 ›› Issue (6) : 302-305.

论著

Author information +

History +

Abstract

Objective To evaluate continuous blood purification (CBP) in treatment of critical patients complicated with hypernatremia. Methods Twenty-nine critical patients complicated with hypernatremia in the intensive care unit were treated with CBP. Sodium concentration in exchange fluid was adjusted according to serum sodium concentration. We analyzed the correlation of serum sodium concentration to patient抯 condition. We also observed changes of serum sodium, serum osmolarity and the acute physiology and chronic health evaluation II (APACHE II) scores before and after CBP. Results Mortality rate of the 29 patients was 68.9% (20/29), and that of craniocerebral disease with hypenatremia was as high as 83.3% (15/18). Serum sodium concentration and the APACHE II scores were significantly higher in death group than in survival group (P＜0.01). We totally performed 113 times of CBP. The average CBP period was 4 (2-10) days and 14 (12-22) hours per day. The fluid amount used for exchange was 4.3L/hour. Serum sodium decreased 14.6mmol/L per day and the rate of the serum sodium change was -0.97mmol/L per hour. After CBP therapy, all patients showed decrease of serum sodium and serum osmolarity and improvement of APACHE II score. During CBP there was no hemodynamic changes (P＜0.01) and the disease condition was stable. Conclusion CBP is a safe and effective measure for the treatment of critical patients with hypernatremia. It must be applied as quickly as possible, especially in craniocerebral disease with hypernatremia.