Treatment on post cardiac surgery patients with multiª²organ dysfunction by continuous renal replacement therapy (CRRT)

    CUI Qin, ZHAO Rong, JIN Zhenª²Xiao, ZHANG Shengª²Li, ZENG Xiao, ZHANG Chiª²Ming

    Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China

    ¡¾Abstract¡¿ AIM: To investigate the effectiveness of continuous renal replacement therapy (CRRT) in post cardioª²pulmonary bypass (CPB) patients with multiª²organ dysfunction syndrome (MODS) and acute renal failure (ARF). METHODS: The circulation stability of twentyª²seven post CPB patients with MODS and ARF was maintained with vascular active drugs and BM25 continuous blood purification system and M60 filter (AN69 membrane) were used to perform the preª²dilution continuous venousª²venous hemofiltration (CVVH). The dialysis solution was the same as literature. The low molecular mass heparin was used for antiª²coagulation. Blood flow was about 200-250 mL/min and the dialysis solution flow rate was 25-100 mL/min for a need of (39¡À10) L dialysis solution for 24 h therapy. The average therapy time was (52¡À13) h. Peripheral venous blood samples were collected before therapy and at 6:00 a.m. everyday after CRRT to detect the serum Cr, Bun, HCO3- and K+. Arterial blood samples were collected to detect the serum pH and HCO3-. The CRRT was stopped when the urine volume of the patient reached 0.5 mL/(kg¡¤h). RESULTS: Twentyª²six of the 27 patients recovered their normal renal functions. Seven of the 11 patients with twoª²organ failure and 3 the 10 patients with threeª²organ failure survived the therapy. Only one of the 6 patients with 4 or more organs failure survived. The overall survival rate was 40%. CONCLUSION: CRRT has a relatively good effect on the treatment of patients with MODS and ARF and can significantly increase the survival rate of these patients. ......