Changes Of Different Doses Of Vit C In Septic AKI Patients Undergoing Continuous Renal Replacement Therapy

Objective: To study the effect of different doses of Vit C on blood Vit C concentration in patients with septic aki(SA-AKI)during continuous renal replacement therapy(CRRT).Methods: From December 2019 to February 2021,patients who were clinically diagnosed as SA-AKI and underwent CRRT were selected as the research subjects.According to the mode of CRRT and the dosage of Vit C,they were divided into group a(CVVH,3g),group b(CVVH,6g)and group c(CVVHDF,6g).During CRRT treatment,serum Vit C levels were detected at different time points(0 h,2h,4h,6h,8h,10h)before and after administration of Vit C,and the pharmacokinetic parameters of Vit C during CRRT were obtained.Serum Vit C concentrations were compared among the three groups.At the same time,observe whether the patients have obvious adverse reactions.SPSS 26.0 was used for statistical analysis.Results: 1.This study included 24 patients with SA-AKI,with an average age of(65.888.216)years,including 15 males and 9 females.The acute physiology and chronic health evaluation II(APACHEⅡ II)score was 25.46±5.42,and the sequential organ failure assessment men(SOFA)score SOFA)13.13±1.98.There were 17 cases(70.83%)in stage 3 and 7 cases(29.17%)in stage 2 of KDIGO(Kidney Disease: Improving Global Outcomes)staging.There are 8 cases in group A,10 cases in group B,and 6cases in group C.There was no significant difference in Age,Sex,KDIGO Stage,APACHEⅡ score,SOFA score,Infection site and Pathogen composition among the three groups(P>0.05).2.During 2.CRRT treatment,when Vit C was not given intravenously,the serum Vit C concentration fluctuated between 6.899 umol/l and16.214 umol/l(10.829 1.663 umol/l),100% patients were in Vit C deficiency(Vit C <23 umol/l),51.1%(23 cases)3.After intravenous infusion of Vit C,the serum Vit C concentration of the three groups at each time point was significantly higher than that before administration(P<0.05).Under the same CVVH mode,the concentration of serum Vit C in 6g Vit C group(group B)was significantly higher than that in 3g Vit C group(group A)(P<0.05).At the same infusion dose(6g),the serum Vit C concentration in CVVH mode group(B group)was significantly higher than that in CVVHDF mode group(C group)at each time point after administration(P < 0.05).4.There was no significant difference in Tmax and t1/2 among the three groups(P>0.05),but there were significant differences in Cmax,AUCall,AUCINF,Vz(observed)and Cl(observed)among the three groups(P<0.05).5.No adverse reactions such as synco Pe,nausea,vomiting,skin flushing,diarrhea,hemolysis and oxalate crystallization were found in the three grou Ps during intravenous infusion of Vit C.Conclusions: 1.Vit C deficiency is widespread in SA-AKI patients during CRRT.2.Intravenous Vit C supplementation can improve the serum Vit C concentration of patients to a certain extent.3.In CVVH mode,the higher dose(6g)improved the serum Vit C concentration more obviously(compared with 3g).Compared with CVVH mode,CVVHDF mode can clear more Vit C.4.It is safe to supplement high dose Vit C(3g and6g)intravenously under CRRT treatment.