The Application Of Continuous Renal Replacement Therapy In Multiple Organ Dysfunction Syndrome

Objective: To investigate the effect of Continuous renal replacement therapy( CRRT) in multiple organ dysfunction syndrome( MODS) .Methods: 21 cases with MODS were selected randomly in the second affiated hospital of dalian medical university from January 2006 to December 2007, who received CRRT. The average age is aged 28-83 (50.14±18.72) years old. There were 10 male patients and 11 female patients. Among these patients , septic shock patients were three cases , patients with refractory heart failure were two cases, patients with acute poisoning were three cases , patients after abdominal surgery were three cases, patients with severe pancreatitis were four cases , patients with liver coma were two cases, severe systemic lupus erythematosus ( SLE) were two cases, trauma patients was one case, patients with primary hyperparathyroidism was one case . All patients had more than two organs disfunction in various degrees, of which two organs disfunction were four cases, three organs disfunction were 10 cases, four organs disfunction were six cases, five organs disfunction was one case, companying with acute renal failure were 19 cases , 12 Patients need mechanical ventilation. Using the GAMBRO Prisma Minual (China)3.03-003 CRRT machine, and GAMBRO M-100 hemofilter for treatment. Monitoring vital signs during the treatment, The levels of BUN, Scr, K, Na and arterial blood gas were measured before and after treatment.Results:1,The levels of BUN, Scr, electrolyte, acid-base imbalance have been better controlled after treatment, there was a significant difference (P <0.05)compared with pretreatment. 2,Before treatment all patients had low blood pressure or volume overload, pulmonary edema in different levels, relying on the blood pressure drugs, diuretics and drugs of possive inotropic action.After treatment patients with edema improved, heart failure corrected, blood pressure and heart rate stabilized (P <0.05).3,2 cases (57.1%)patients survived after CRRT , nine cases died (42.9%), in which the mortality rate of the two organs disfunction is 25.0 %, three organs disfunction is 50.0%, four organs disfunction is 33.3%, 5 organs disfunction is 100.0%.All severe pancreatitis patients survived.Conclusions : Continuous renal replacement therapy can precisely control capacity load, and maintain fluid balance and hemodynamic stability, also can removal water slowly, continuously, gradually.CRRT can better improve blood biochemical indicators, correct azotemia, adjust liquid,electrolytes and acid-base disorders , improve the internal environment ,and use safely, fit for the critically ill patients. Continuous renal replacement therapy is an effective method of multiple organ dysfunction syndrome treatment .