ABSTRACT
Background: Several severe earthquakes hit China in recent years. Critically ill earthquake victims were usually complicated with crush injuries and acute renal injury (AKI). CRRT were performed in these patients and received very satisfactory results.
Methods: Twenty-three patients received CRRT treatment because of MODS and sepsis or IHD uncontrolled volume overload or electrolytes disorders. Replacement fluid was given at a speed of 3-4L/h. Regional citrate anticoagulation was applied. Clinical characters and laboratory results were collected and analyzed.
Results: Application of CRRT improved the outcome of critically ill earthquake victims. Only 5 patients complicated with MODS died during treatment. This result indicated a much lower patient’s mortality comparing with previous report. Dead patients were characterized as older (63.4 vs 25.9 yr); with much severer injuries and higher APACHE II score (32.6±8.6 vs 21.1±6.7) comparing with survived patients. APACHE II score was decreased significantly after CRRT treatment. Renal dysfunction and electrolytes disorders were controlled after treatment. Dramatic reduction was observed in serum CK, and Myoglobin levels after CRRT. Injured limbs of several patients were persevered after CRRT treatment instead of amputation. One year follow up indicated only 1 patients developed chronic renal failure. No severe complications were noticed during the CRRT.
Conclusion: CRRT could efficiently treat patients with earthquake caused ARF especially those complicated with MODS, sepsis or IHD uncontrolled hemodynamic status. It may also be helpful to the preservation of injured limbs.
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