Intermittent Hemodialysis for Managing Metabolic Acidosis during Resuscitation of Septic Shock: A Descriptive Study

4Citations
Citations of this article
9Readers
Mendeley users who have this article in their library.
Get full text

Abstract

Objectives: Septic shock is often complicated by severe metabolic acidosis, for which renal replacement therapy may be considered. However, little is known about the use of intermittent hemodialysis to manage this condition. The aim of this study was to compare physiologic and biochemical variables and vasopressor requirements before and after intermittent hemodialysis among patients who received intermittent hemodialysis to manage metabolic acidosis during resuscitation of septic shock. Design: This retrospective, cross-sectional study was conducted between April 2014 and September 2015. Settings: The ICU of a non-university-Affiliated teaching hospital. Patients: Patients who were admitted to the ICU with septic shock and underwent intermittent hemodialysis to manage metabolic acidosis within 48 hours after the diagnosis of septic shock. Measurements and Main Results: The main outcomes were mean arterial pressure, minute ventilator volume, norepinephrine requirement, bicarbonate and pH before and after intermittent hemodialysis. Of 1,190 patients screened, 34 were included, and 33 accomplished a planned session of intermittent hemodialysis. After intermittent hemodialysis, an increased mean arterial pressure (+9.0 mm Hg; 95% CI, 6-13; p < 0.001), decreased minute ventilatory volume (-2.0 L/min; 95% CI,-3.3 to 0.8; p = 0.002), decreased norepinephrine requirement (-0.07 µg/kg/min; 95% CI,-0.12 to-0.02; p = 0.009), increased bicarbonate level (+7.2 mmol/L; 95% CI, 6.1-8.3; p < 0.001), and increased pH (+0.17; 95% CI, 0.13-0.21; p < 0.001) were observed in comparison to those before intermittent hemodialysis. Conclusions: In conclusion, intermittent hemodialysis appeared to be feasible and to stabilize hemodynamic and respiratory conditions in patients with septic shock complicated by metabolic acidosis during resuscitation.

References Powered by Scopus

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

4886Citations
N/AReaders
Get full text

KDIGO clinical practice guidelines for acute kidney injury

3988Citations
N/AReaders
Get full text

Acute renal failure in critically ill patients: A multinational, multicenter study

3610Citations
N/AReaders
Get full text

Cited by Powered by Scopus

The incidence, risk factors and outcomes of acute kidney injury in critically ill patients undergoing emergency surgery: a prospective observational study

13Citations
N/AReaders
Get full text

Effect of CytoSorb Coupled with Hemodialysis on Interleukin-6 and Hemodynamic Parameters in Patients with Systemic Inflammatory Response Syndrome: A Retrospective Cohort Study

10Citations
N/AReaders
Get full text

Changing the terminology from kidney replacement therapy to kidney support therapy

4Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Nogi, K., Shiraishi, A., Yamamoto, R., Sasano, M., Matsumoto, T., Karumai, T., & Hayashi, Y. (2019). Intermittent Hemodialysis for Managing Metabolic Acidosis during Resuscitation of Septic Shock: A Descriptive Study. Critical Care Explorations, 1(12), E0065. https://doi.org/10.1097/CCE.0000000000000065

Readers' Seniority

Tooltip

Professor / Associate Prof. 1

100%

Readers' Discipline

Tooltip

Medicine and Dentistry 4

100%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 79

Save time finding and organizing research with Mendeley

Sign up for free