碳酸氢钠预降在连续静脉-静脉血液滤过局部柠檬酸抗凝中的应用。

IF 1.8 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2025-08-23 DOI:10.1159/000548161

Dingye Wu, Tao Zhou, Junfeng Heng, Fengming Liang, Qiuhui Wang, Hongyang Xu

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引用次数: 0

摘要

简介：本研究旨在探讨碳酸氢钠预降在连续静脉-静脉血液滤过（CVVH）与局部柠檬酸抗凝（RCA）期间的有效性。方法：将CVVH合并RCA患者随机分为对照组和预处理组，预处理组在治疗3小时后降低碳酸氢钠浓度至所需水平。研究的重点是CVVH期间pH、碳酸氢钠离子水平的变化以及碳酸氢钠剂量在不同间隔的调整频率。结果：2023年7月至2024年2月治疗的41例患者（对照组20例，术前治疗组21例），人口学及临床特征无统计学差异。与对照组（26.57±2.17 mmol/L, P < 0.05）相比，预减压组第4小时碳酸氢盐离子水平（23.62±2.66 mmol/L）明显降低，需要调整碳酸氢盐的次数较少（0[0,1]次，对照组2[1,3]次，P < 0.05）。结论：在CVVH期间使用RCA预还原碳酸氢钠可以最大限度地减少碳酸氢钠离子波动，减少剂量调整的需要。

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Application of Sodium Bicarbonate Prereduction in Regional Citrate Anticoagulation for Continuous Veno-Venous Hemofiltration.

Introduction: This study aimed to explore the effectiveness of sodium bicarbonate prereduction during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA).

Methods: Patients undergoing CVVH with RCA were randomly divided into a control group and a prereduction group, with the latter receiving reduced sodium bicarbonate concentration levels to achieve the desired level after 3 h of treatment. The investigation focused on variations in pH, bicarbonate ion levels, and the frequency of sodium bicarbonate dosage adjustments at different intervals during CVVH.

Results: The 41 participants (20 in the control group, 21 in the prereduction group) treated from July 2023 to February 2024 had no statistically significant differences in demographic or clinical characteristics. The prereduction group demonstrated significantly lower bicarbonate ion levels in the 4th hour (23.62 ± 2.66 mmol/L) compared with the control group (26.57 ± 2.17 mmol/L, p < 0.05) and required fewer bicarbonate adjustments (0 [0,1] times vs. 2 [1,3] times in the control group, p < 0.05).

Conclusion: Sodium bicarbonate prereduction during CVVH using RCA minimises bicarbonate ion fluctuations and reduces the need for dosage adjustments.

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.