概括
在连续静脉血过 (CVVH) 过程中使用区域酸盐抗凝剂 (RCA) 预降低酸盐,使酸盐水平稳定. 在接受CVVH的患者中,这种方法可以最大限度地减少波动,并减少频繁调整剂量的需要.
科学领域:
- 肝脏病学
- 危急护理医学
- 生物化学
背景情况:
- 持续静脉血过 (CVVH) 是一种重要的置换疗法.
- 区域酸盐抗凝药 (RCA) 常用于CVVH,但可能会影响酸平衡.
- 控制酸平衡,特别是二碳酸盐水平,在RCA的CVVH期间至关重要.
研究的目的:
- 在CVVH与RCA中预降低二碳酸度的有效性.
- 评估二碳酸预降低对pH和二碳酸离子水平的影响.
- 为了确定预降低是否会减少二碳酸盐剂量调整的频率.
主要方法:
- 在接受CVVH和RCA的患者中进行了随机对照试验.
- 患者被分为对照组和减肥前组.
- 在整个治疗期间,监测双碳酸盐水平,pH值和剂量调整.
主要成果:
- 与对照组相比,在4小时内,预减剂组的二碳酸盐离子水平显著降低 (23. 62 ± 2. 66 vs 26. 57 ± 2. 17 mmol/ L).
- 在减肥前的组中,需要进行较少的二碳酸盐调整 (0 [0,1] 对比 2 [1,3] 倍).
- 两组之间没有发现人口或临床特征的显著差异.
结论:
- 在RCA的CVVH期间,酸碳酸盐预减剂有效控制酸碳酸盐水平.
- 这种策略将二碳酸离子的波动降到最低,从而提高了酸稳定性.
- 通过减少频繁调整二碳酸盐剂量的必要性,预减剂可以简化治疗.
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