Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, pozorovací studie
- Klíčová slova
- Acidemia, continuous veno-venous hemodialysis, extended daily hemodialysis, intermittent hemodialysis, metabolic acidosis, methanol poisoning,
- MeSH
- acidóza chemicky indukované terapie MeSH
- akutní nemoc MeSH
- časové faktory MeSH
- dialýza ledvin metody MeSH
- dospělí MeSH
- hydrogenuhličitany metabolismus MeSH
- kohortové studie MeSH
- koncentrace vodíkových iontů MeSH
- lidé středního věku MeSH
- lidé MeSH
- methanol otrava MeSH
- mladiství MeSH
- náhrada funkce ledvin metody MeSH
- prognóza MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- srovnávací studie MeSH
- Názvy látek
- hydrogenuhličitany MeSH
- methanol 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.
c J Heyrovský Institute of Physical Chemistry of the AS CR v v i Prague Czech Republic
Department of Anesthesiology and Resuscitation Kladno City Hospital Kladno Czech Republic
e Department of Internal Medicine Tomas Bata Regional Hospital Zlin Czech Republic
g Department of Anesthesiology and Resuscitation Znojmo City Hospital Znojmo Czech Republic
h Department of Anesthesiology and Resuscitation Benešov City Hospital Benešov Czech Republic
i Department of Anesthesiology and Resuscitation Ostrava City Hospital Ostrava Czech Republic
j Department of Anesthesiology and Intensive Medicine Havířov Hospital Havířov Czech Republic
k Department of Anesthesiology and Intensive Medicine Karvina Raj Hospital Orlova Czech Republic
m Department of Internal Medicine Frydek Mistek City Hospital Frydek Mistek Czech Republic
o Department of Anesthesiology and Resuscitation Masaryk Hospital Ústínad Labem Czech Republic
q Department of Internal Medicine Faculty Hospital Brno Brno Czech Republic
r Department of Internal Medicine Ostrava City Hospital Ostrava Czech Republic
s Department of Clinical Biochemistry Tomas Bata Regional Hospital Zlin Czech Republic
t Medical School Australian National University Canberra Australia
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