Kidney Injury, Acute
Conditions
Keywords
Continuous veno-venoous haemofiltration, Plasma lactate, Critical illness, Acute kidney injurytissue perfusion, Multiple organ dysfunction syndrome
Brief summary
Continuous Veno-Venous Hemofiltration (CVVH) can eliminate metabolic products effectively and replace renal function partly. It is widely used in intensive care units (ICUs), especially for patients with acute kidney injury/failure in an unstable hemodynamic status. Lactate is a molecule smaller than glucose, which can pass through filtration membrane freely in CVVH. Therefore, the blood lactate concentrations would no longer reflect tissue oxygenation status in patients with unstable hemodynamic status. However, there is no prospective study evaluated the effect of CVVH on lactate removal in critically ill patients. The influence of different dose of CVVH on lactate elimination is not clear in patients with different level of serum lactate. Our study aimed to find out how the dose of CVVH effects on lactate clearance, and then re-estimate the prognostic value of lactate in critically ill patients with CVVH.
Interventions
OTHERPlasma lactate were measured
Three different doses (20 ml/kg/h, 35 ml/kg/h and 45 ml/kg/h) of CVVH were applied to critically ill patients who experiencing CVVH. Each dose of CVVH was sequentially gave to each patient and lasted for 30 minutes separately
Sponsors
First Affiliated Hospital, Sun Yat-Sen University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. The critical ill patients with acute kidney injury 2. Patients requiring continuous veno-venous hemofiltration 3. APACHE II scores more than 12 4. Arterial lactate is higher than 0.5mmol/L but lower than 15mmol/L (due to the sensitivity and optimal measuring range of the equipment) 5. Continuous veno-venous hemofiltration for at least 12 hrs 6. Hemo-filter age of \<24 hrs
Exclusion criteria
1. APACHE II scores lower than 12 2. patients' age are more than 75Y or lower than 18Y
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| plasma lactate | 30 minutes | Each dose of CVVH was lasted for 30 minutes separately. Blood samples were draw pre-(A) and post-dialyzer (V) site after each dosage of CVVH was carried out for 30 minutes and then plasma lactates were measured immediately |
Countries
China
Outcome results
None listed