継続的な静脈静脈血液濾過のための地域性酸塩抗凝固剤における二酸化ナトリウム前縮小の適用
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PubMedで要約を見る
まとめ
この要約は機械生成です。局所チラート抗凝固 (RCA) による連続静脈静脈血液濾過 (CVVH) 中のビカルボネート前減少は,ビカルボネート濃度を安定させる. この方法は波動を最小限に抑え,CVVHを患っている患者で頻繁に投与量を調整する必要性を軽減します.
科学分野
- 腎臓科
- クリティカル ケア 医療
- 生物化学
背景
- 継続的な静脈静脈血液濾過 (CVVH) は重要な腎置換療法です.
- 地域性シトラート抗凝固薬 (RCA) は,CVVHで一般的に使用されますが,酸塩バランスに影響を及ぼします.
- 酸塩バランスの管理は,特にビカルボネートレベルは,RCAのCVVHでは極めて重要です.
研究 の 目的
- RCAによるCVVHにおける二酸化ナトリウム濃度の前減少の有効性を評価する.
- 塩酸ビカルボネート前減少がpHと塩酸ビカルボネートイオンレベルに与える影響を評価する.
- 減量前療法がバイカーボネート用量調整の頻度を下げるかどうかを判断する.
主な方法
- CVVH と RCA を受けた患者でランダム化制御試験が行われました.
- 患者は対照群と減量前群に分けられました.
- ビカルボネート濃度,pH,および投与量の調整は,治療期間中ずっとモニタリングされた.
主要な成果
- 減量前のグループは,対照群 (23. 62 ± 2. 66 対 26. 57 ± 2. 17 mmol/ L) と比較して,4時間目には著しく低い二酸化炭素イオンレベルを示した.
- 減量前のグループでは二酸化炭素の調整が少なくなった (0 [0,1] 対 2 [1,3] 倍).
- 人口統計学的または臨床的特徴の有意な差異は観察されなかった.
結論
- RCAのCVVH中に bikarbonateのレベルを管理するのに有効です.
- この戦略は二酸化炭素イオンの変動を最小限に抑え,より高い酸塩安定性をもたらします.
- 減量前治療は,頻繁なバイカーボネート用量調整の必要性を減らすことで治療を簡素化します.
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