Abstract:

Ｏｂｊｅｃｔｉｖｅ：To observe the effects of continuous venovenous hemofiltration (CVVH) on the treatment of severely burned patients with acute severe hypernatremia.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of thirteen severely burned patients with acute severe hypernatremia who received the CVVH treatment were admitted to our burned ICU between March 2011 and March 2015. The sodium concentration of the replacement fluid was adjusted by adding 3% or 10% sodium chloride. The sodium level of the replacement fluid was initially set to be lower than the serum sodium level by 8 mmol/L and was reduced by 2 mmol/L every 4 hours.
Ｒｅｓｕｌｔｓ：They were an average age of 491 years and had an average total burn surface area of 642%. 3 patients died in followup of 28day. After the CVVH treatment, all patients showed a significant reduction in APACH II score（210 (195~250) vs 246 (220~285),P<0001） and heartbeat (107 (930~120）vs 123 (116~136) bpm/min, P=0028). Likewise, the serum levels of urea and creatinine were decreased from 227 (154~343) to 134 (121~155）mmol/L (P=0018) and from 257 (146~399) μmol/L to 168 (106~241) (P=0014), respectively. The serum sodium reduction rate of 062 (034~089) mmol/L/h, all patients experienced a successful correction of hypernatremia within 48hrs.
Ｃｏｎｃｌｕｓｉｏｎ：Our results indicated that CVVH with gradient sodium replacement fluid was suitable for treating the acute severe hypernatremia in severely burned patients.