床边持续静-静脉血液滤过抢救ICU重度高血钾的临床观察

Continuous Veno-venous Hemoffltration for Emergency Treatment of Severe Hyperkalemia in ICU

目的:观察床边持续静-静脉血液滤过(CVVH)抢救14例ICU重度高血钾的有效性及安全性。方法:14例并发重度高血钾的重危患者给予床边CVVH,先使用无钾置换液,待血钾浓度降至正常后,再逐渐增加置换液中钾离子浓度至平衡状态。对比治疗前及治疗开始后1、2、4、6、12、24h血清钾浓度。结果:1h之内所有患者血钾浓度均有效下降,6h之内全部降至正常范围,12、24h保持于正常水平;治疗过程中生命体征稳定。结论:ICU床边CVVH用于抢救重危患者并发的重度高血钾安全、有效。

Objective: To investigate the efficacy and safety of continous veno-venous hemofiltration(CWH) for treatment of severe hyperkalemia in ICU. Methods: 14 critical patients in the ICU with severe hyperkalemia underwent CWH. The replacement solution without potassium was used at first and then the concentration of potassium in the replacement solution increased gradually, according to the serum potassium level.The serum potassium level before CWH was compared with that in 1,2,4,6,12,24 hours after CWH. Results: All patients' serum potassium concentration came to decrease within 1 hour, the potassium level was brought down to normal in 6 hours, and it kept at the normal level in 12 and 24 hours. Vital signs maintained stable during CWH. Conclusion: CWH in ICU is effective and safe to treat critlal patients with severe hyperkalemia.