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Effects of continuous venous-venous hemofiltration on heat stroke patients: a retrospective study.
MedLine Citation:
PMID:  22182867     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Heat stroke (HS) is a fatal illness characterized by an elevated core body temperature above 40°C and complicated with rhabdomyolysis and acute renal failure. We retrospectively analyzed the effect of continuous veno-venous hemofiltration (CVVH) in patients with HS.
METHODS: : A total of 16 patients with HS were retrospectively analyzed. All patients were treated by CVVH for at least 96 hours, and CVVH was initiated with replacement fluid between 25°C and 30°C for 2 hours to 2.5 hours, and 36°C thereafter. The vital signs were monitored and blood samples were collected during CVVH to measure serum urea, creatinine, myoglobin, creatine kinase, and total bilirubin.
RESULTS: : All patients survived. The core temperature of the patients decreased from 41.3 ± 0.2°C to 38.7 ± 0.1°C after 2 hours and to 36.7 ± 0.1°C after 5 hours during CVVH (p < 0.05). Compared with values before starting CVVH, there were remarkable improvements in mean arterial blood pressure, heart rate, and oxygenation index (p < 0.05). The serum creatinine, urea, myoglobin, and creatine kinase decreased significantly (p < 0.05), while the bilirubinemia had no obvious decline (p > 0.05). The scores of APACHE II and arterial lactate had also obvious decline (p < 0.05). The hemodynamic variables were stabilized during CVVH, and no obvious side effects related to CVVH were found.
CONCLUSIONS: : CVVH is safe and feasible in the treatment of patients with HS by lowering core temperature, removal of myoglobin, support of multiorgan function, and modulating systemic inflammatory response syndrome (SIRS). The impact of CVVH on patient outcome, however, still needs proof by larger randomized controlled trials.
Authors:
Feihu Zhou; Qing Song; Zhiyong Peng; Liang Pan; Hongjun Kang; Sheng Tang; Hui Yue; Hui Liu; Fei Xie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  71     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1562-8     Citation Subset:  AIM; IM    
Affiliation:
From the Department of Critical Care Medicine (F.Z., Q.S., L.P., H.K., S.T., H.Y., H.L.F.X.), Chinese people's liberation army general hospital, Beijing, People's Republic of China and The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center (Z.P.), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
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