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Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning
S. Zakharov, D. Pelclova, T. Navratil, J. Belacek, J. Latta, M. Pisar, J. Rulisek, J. Leps, P. Zidek, C. Kucera, R. Bocek, M. Mazur, Z. Belik, J. Chalupa, V. Talafa, K. Kodras, D. Nalos, C. Sedlak, M. Senkyrik, J. Smid, T. Salek, DM. Roberts, KE. Hovda,
Language English Country England, Great Britain
Document type Comparative Study, Journal Article, Observational Study
Grant support
NV16-27075A
MZ0
CEP Register
Digital library NLK
Full text - Article
NLK
Medline Complete (EBSCOhost)
from 2005-01-01 to 1 year ago
- MeSH
- Acidosis chemically induced therapy MeSH
- Acute Disease MeSH
- Time Factors MeSH
- Renal Dialysis methods MeSH
- Adult MeSH
- Bicarbonates metabolism MeSH
- Cohort Studies MeSH
- Hydrogen-Ion Concentration MeSH
- Middle Aged MeSH
- Humans MeSH
- Methanol poisoning MeSH
- Adolescent MeSH
- Renal Replacement Therapy methods MeSH
- Prognosis MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Comparative Study MeSH
CONTEXT: Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined. OBJECTIVE: We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning. METHODS: The study was designed as observational cohort study. The mean time for an increase of 1 mmol/L HCO3(-), 0.01 unit arterial blood pH, and the total time for correction of HCO3(-) were determined in IHD- and CRRT-treated patients. RESULTS: Data were obtained from 18 patients treated with IHD and 13 patients treated with CRRT. At baseline, CRRT group was more acidemic than IHD group (mean arterial pH 6.79 ± 0.10 versus 7.05 ± 0.10; p = 0.001). No association was found between the rate of acidemia correction and age, weight, serum methanol, lactate, formate, and glucose on admission. The time to HCO3(-) correction correlated with arterial blood pH (r= -0.511; p = 0.003) and creatinine (r = 0.415; p = 0.020). There was association between the time to HCO3(-) correction and dialysate/effluent and blood flow rates (r= -0.738; p < 0.001 and r= -0.602; p < 0.001, correspondingly). The mean time for HCO3(-) to increase by 1 mmol/L was 12 ± 2 min for IHD versus 34 ± 8 min for CRRT (p < 0.001), and the mean time for arterial blood pH to increase 0.01 was 7 ± 1 mins for IHD versus 11 ± 4 min for CRRT (p = 0.024). The mean increase in HCO3(-) was 5.67 ± 0.90 mmol/L/h for IHD versus 2.17 ± 0.74 mmol/L/h for CRRT (p < 0.001). CONCLUSIONS: Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.
Department of Anesthesiology and Intensive Medicine Havířov Hospital Havířov Czech Republic
Department of Anesthesiology and Intensive Medicine Karvina Raj Hospital Orlova Czech Republic
Department of Anesthesiology and Resuscitation Benešov City Hospital Benešov Czech Republic
Department of Anesthesiology and Resuscitation Kladno City Hospital Kladno Czech Republic
Department of Anesthesiology and Resuscitation Masaryk Hospital Ústínad Labem Czech Republic
Department of Anesthesiology and Resuscitation Ostrava City Hospital Ostrava Czech Republic
Department of Anesthesiology and Resuscitation Znojmo City Hospital Znojmo Czech Republic
Department of Clinical Biochemistry Tomas Bata Regional Hospital Zlin Czech Republic
Department of Internal Medicine Faculty Hospital Brno Brno Czech Republic
Department of Internal Medicine Frydek Mistek City Hospital Frydek Mistek Czech Republic
Department of Internal Medicine Ostrava City Hospital Ostrava Czech Republic
Department of Internal Medicine Tomas Bata Regional Hospital Zlin Czech Republic
Medical School Australian National University Canberra Australia
References provided by Crossref.org
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- $a Zakharov, Sergey $u Department of Occupational Medicine, First Faculty of Medicine , Toxicological Information Centre, Charles University and General University Hospital , Prague , Czech Republic.
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- $a Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning / $c S. Zakharov, D. Pelclova, T. Navratil, J. Belacek, J. Latta, M. Pisar, J. Rulisek, J. Leps, P. Zidek, C. Kucera, R. Bocek, M. Mazur, Z. Belik, J. Chalupa, V. Talafa, K. Kodras, D. Nalos, C. Sedlak, M. Senkyrik, J. Smid, T. Salek, DM. Roberts, KE. Hovda,
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- $a CONTEXT: Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined. OBJECTIVE: We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning. METHODS: The study was designed as observational cohort study. The mean time for an increase of 1 mmol/L HCO3(-), 0.01 unit arterial blood pH, and the total time for correction of HCO3(-) were determined in IHD- and CRRT-treated patients. RESULTS: Data were obtained from 18 patients treated with IHD and 13 patients treated with CRRT. At baseline, CRRT group was more acidemic than IHD group (mean arterial pH 6.79 ± 0.10 versus 7.05 ± 0.10; p = 0.001). No association was found between the rate of acidemia correction and age, weight, serum methanol, lactate, formate, and glucose on admission. The time to HCO3(-) correction correlated with arterial blood pH (r= -0.511; p = 0.003) and creatinine (r = 0.415; p = 0.020). There was association between the time to HCO3(-) correction and dialysate/effluent and blood flow rates (r= -0.738; p < 0.001 and r= -0.602; p < 0.001, correspondingly). The mean time for HCO3(-) to increase by 1 mmol/L was 12 ± 2 min for IHD versus 34 ± 8 min for CRRT (p < 0.001), and the mean time for arterial blood pH to increase 0.01 was 7 ± 1 mins for IHD versus 11 ± 4 min for CRRT (p = 0.024). The mean increase in HCO3(-) was 5.67 ± 0.90 mmol/L/h for IHD versus 2.17 ± 0.74 mmol/L/h for CRRT (p < 0.001). CONCLUSIONS: Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.
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