高二碳酸盐替代液和持续静脉静脉血过期间与区域酸盐抗凝剂的pH正常化时间:一个回顾性单中心队列研究
Timo Mayerhöfer1, Paul Köglberger1,2, Fabian Perschinka1
1Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.
Clinical kidney journal
|May 13, 2025
概括
在连续静脉静脉血过 (CVVH) 中使用区域酸盐抗凝剂 (RCA) 的高二碳酸盐替代液有效地纠正血酸性. 然而,血的纠正速度较慢,正常pH值的患者经历了进一步的增加,表明明显的酸障碍动力学.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 生物化学 生物化学
背景情况:
- 在替代疗法之前,重症患者中常见的是酸性疾病.
- 持续置换疗法 (CRRF) 是一种常见的干预措施,用于管理这些患者的液体和电解质失衡.
- 在CRRF中的替代流体 (RF) 的组成可能会影响酸干扰的管理.
研究的目的:
- 为了研究高二碳酸盐替代液 (30 mmol/L,Phoxilium®) 对经过连续静脉血过 (CVVH) 治疗的重症患者先前存在的酸性疾病的影响.
- 在CVVH期间使用区域酸盐抗凝剂 (RCA) 分析不同初始pH值的患者的酸校正动力学.
主要方法:
- 这是一项单一中心的回顾性研究,涉及64名接受CVVH,区域酸盐抗凝剂 (RCA) 和高二碳酸盐RF (Phoxilium®) 治疗的患者.
- 患者根据他们的初始pH值 (酸性,性或正常) 进行了分层.
- 酸参数,包括pH值,二碳酸和过多,在CVVH开始后72小时内进行监测.
主要成果:
- 在CVVH开始时,56.3%的患者出现了酸性血,12.5%有性血,32.3%的pH正常.
- 患有酸血症的患者在8小时内呈现出迅速的pH正常化.
- 血病患者需要更长时间的校正 (48小时),而正常pH值的患者则在正常范围内进一步提高pH值.
- 在所有患者中,二碳酸盐和酸的过量水平从24小时持续增加到72小时.
结论:
- 在CVVH中使用的高二碳酸盐替代液体具有RCA影响酸平衡.
- 对于不同的先前存在的酸性疾病,观察到明显的纠正模式.
- 需要进一步的前性研究来证实临床相关性,并优化射频组合,以改善患者的治疗结果.
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