Comparison of different substitution fluid for hemofiltration in patients with dysfunction of glycometabolism and MODS caused by trauma / 中华急诊医学杂志

ABSTRACT

Objective To find a better composition substitution fluid for continuous venovenous hemofiltration (CWH) comparing with the Port's composition substitution fluid,and to evaluate its efficiency and prognosis on patients with dysfunction of glycometabolism and multiple organ dysfunction syndrome (MODS) caused by trauma. Method Totol of 134 patients in the Firist Affiliated Hospotal of the Fourth Miliatary Medicial University,with glycometabolism dysfunction and MODS caused by trauma between Janurary 2001 and December 2006 were treated with CVVH.They were divided into two groupsthe Port's composition substitution fluid which glucose concentration was 59.1 mmoL/L (group A,59 cases) and the new substitution fluid which glucose concentration is 11.8 mmol/L (group B,75 cases).The changes of electrolytes,arterial blood gas analysis,blood glucose and osmolarity during CVVH were observed.Results The mortality in group A was significantly higher than that in group B (64.4 % vs 40.0 %,P = 0.005).Before treated with CVVH,there was no significant differences of APACHEⅡscores between group A and group B.Either in the survival patients or in non-survivors,the APACHEⅡscores in group B were significantly higher than that in group A (P