INFLUENCE OF CONTINUOUS HEMOFILTRATION-RELATED HYPOTHERMIA ON HEMODYNAMIC VARIABLES AND GAS-EXCHANGE IN SEPTIC PATIENTS

被引:54
作者
MATAMIS, D
TSAGOURIAS, M
KOLETSOS, K
RIGGOS, D
MAVROMATIDIS, K
SOMBOLOS, K
BURSZTEIN, S
机构
[1] G PAPANIKOLAOU GEN HOSP,INTENS CARE UNIT,THESSALONIKI,GREECE
[2] G PAPANIKOLAOU GEN HOSP,RENAL UNIT,THESSALONIKI,GREECE
[3] RAMBAM MED CTR,INTENS CARE UNIT,HAIFA,ISRAEL
关键词
ACUTE RENAL FAILURE; SEPSIS; HEMOFILTRATION; HEMODYNAMICS; HYPOTHERMIA; GAS EXCHANGE; OXYGEN CONSUMPTION;
D O I
10.1007/BF01710654
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To investigate the influence of continuous haemofiltration (CHF) on haemodynamics, gas exchange and core temperature in critically ill septic patients with acute renal failure. Patients and methods: In 20 patients (17 male, 3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic variables were measured at regular intervals during the first 48 h of haemofiltration. Baseline data were compared to those obtained 30 min after initiating CHF and also to those during hypothermia (if observed). Main results: Haemodynamic variables remained remarkably constant throughout the study period. In patients with a relatively low ultrafiltration rate (855+/-278 ml/h) temperature did not change, while in patients with a high ultrafiltration rate (1468+/-293 ml/h) core temperature significantly decreased from 37.6+/-0.9-degrees-C to 34.8+/-0.8-degrees-C (p < 0.001). There was a statistically significant correlation between temperature decrease and ultrafiltration rate (r = -0.68, Y = 1.8-0.003X, p < 0.01). Hypothermic patients also showed a mean decrease in VO2 from 141+/-22 ml/min/m2 to 112+/-22 ml/min/m2 (p < 0.01) with a concomitant increase in PaO2 from 103+/-37 mmHg to 140+/-42 mmHg (p < 0.001) and in PvO2BAR from 35+/-4 mmHg to 41+/-5 mmHg (p < 0.001). Conclusions: Continuous haemofiltration does not cause significant alternations in haemodynamic variables. 2) Hypothermia frequently occurs in patients undergoing continuous haemofiltration with high ultrafiltration rates. These hypothermic patients show a reduction in VO2 leading to an increase in PvO2BAR and PaO2. This mild hypothermia in these circumstances has no evident deleterious effects.
引用
收藏
页码:431 / 436
页数:6
相关论文
共 22 条
[1]   USE OF EXTRACORPOREAL SUPPORTIVE TECHNIQUES AS ADDITIONAL TREATMENT FOR SEPTIC-INDUCED MULTIPLE ORGAN FAILURE PATIENTS [J].
BARZILAY, E ;
KESSLER, D ;
BERLOT, G ;
GULLO, A ;
GEBER, D ;
BENZEEV, I .
CRITICAL CARE MEDICINE, 1989, 17 (07) :634-637
[3]   PULMONARY GAS-EXCHANGE DURING HEMODIALYSIS [J].
BOUFFARD, Y ;
VIALE, JP ;
ANNAT, G ;
GUILLAUME, C ;
PERCIVAL, C ;
BERTRAND, O ;
MOTIN, J .
KIDNEY INTERNATIONAL, 1986, 30 (06) :920-923
[4]  
BURCHARDI H, 1989, UPDATE INTENSIVE CAR, P340
[5]  
BURSZTEIN S, 1989, ENERGY METABOLISM IN, P27
[6]  
DANTZKER DR, 1990, UPDATE INTENSIVE CAR, P131
[7]  
DEBROE ME, 1989, REPLACEMENT RENAL FU, P828
[8]  
DUBOIS EF, 1954, ANNU REV PHYSIOL, V16, P125
[9]  
ESCHBACH JW, 1989, REPLACEMENT RENAL FU, P859
[10]  
FROMM RE, 1987, OXYGEN TRANSPORT CRI, P249