The Clinicle Study Of Continuous Blood Purification On Hypernatremia In ICU

Objection: The study is aimed to observe the patients with hypernatremia in ICU, analyses their etiological factor, contrast the effects of two treatment modes between Continuous Blood Purification and expectant treatment, approach the internal association with hypernatremia and sepsis, in the premise of assign medical resource reasonable, search the better treatment of hypernatremia, and sepsis, and then to lower the case fatality in these patients.Method: Used the control study, we reviewed retrospectively ninety hypernatremia patients (serum natrium≥150mmol/L) in ICU of Tianhe hospital during September, 2005 to September, 2007. Based on different treatment models, ninety patients were divided into two groups, one is the continuous blood purification(CBP) group for 52 cases and the other is expectant treatment group for 38 cases. All of these patients' vital signs, clinic status and laboratory data,variation of acute physiology and chronic health evaluation (APACHEâ…¡) were observed at the moment who just into ICU, the day emerged hypernatremia, 48 hours after the first treatment and 24 hours after the end of the last treatment in critical stage. We also evaluated and compared the difference prognosis between the two groups.Results:â‘ We realized that the vary of APACHEâ…¡score and serum natrium in the two groups had no statistical difference at the moment who just into ICU or one emerged hypernatremia (P>0.05). At the other moments, the APACHE II score and serum natrium of CBP group were lower than the ones of expectant treatment group (P<0.05).â‘¡In this study, the case fatality of two groups had distinguished statistical difference: CBP group[32.7%] vs. expectant treatment group [57.9%]( P<0.05).â‘¢When the treatments were finished, the observation exhibited that the values of crystal osmotic pressure, creatinine, C reactive protein(CRP) in CBP group were lower than expectant treatment group (P<0.05);and the values also lower than the ones before treatment, the varies had statistical difference(P<0.05). In two groups, the varies of MAP, SpO₂ and oxygenation index had statistical difference(P<0.05), CBP group was higher than the other group (P<0.05), and after the treatments, all of these values were higher then before, existed statistical difference(P<0.05).Conclusions: Treat hypernatremia by continuous blood purification, has stable haemodynamics and satisfactory effect, can improve the patients' prognosis, and be helpful for discriminating risk factor of sepsis early, then provide positive intervention. So, CBP is one of the effective methods in the treatment of acute hypernatremia.