Continuous veno-venous hemodiafiltration plus activated charcoal hemoperfusion in treatment of multiple organ dysfunction syndrome caused by fish bile poisoning: one case

doi:10.3969/j.issn.1004-583X.2022.08.012

Abstract

Abstract:

Objective To observe the effect of continuous veno-venous hemodiafiltration (CVVHDF) plus activated charcoal hemoperfusion in treatment of multiple organ dysfunction syndrome (MODS) caused by bile poisoning. Methods The patient was treated with CVVHDF combined with HP (activated charcoal),and the trend of liver function, kidney function, cardiac function, coagulation function and other indicators as well as its efficacy after the treatment were observed. Results After 3 HP (activated charcoal) and 3 CVVHDF treatments, the liver function, kidney function, cardiac function, coagulation function and other indicators of this patient returned to normal when discharged. Conclusion On the basis of comprehensive treatment, CVVHDF plus activated charcoal hemoperfusion and other comprehensive treatment can improve the patients'perfusion of tissues and organs and blood biochemical indicators, as well as the patients' prognosis and disease outcome.

Key words: multiple organ failure, fish bile poisoning, hemoperfusion (activated charcoal), hemodialysis

CLC Number:

R365

Liu Peihua, Yang Qian, Liu Zhiqiang, Liang Lu. Continuous veno-venous hemodiafiltration plus activated charcoal hemoperfusion in treatment of multiple organ dysfunction syndrome caused by fish bile poisoning: one case[J]. Clinical Focus, 2022, 37(8): 738-742.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.08.012

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I8/738

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References 24

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项目	正常范围	1 d	2 d	3 d	4 d	5 d	6 d
CKMB(ng/ml)	0~2.03	37.5	20.6	9.29	9.7	6.24	1.42
Myo(ng/ml)	0~61.5	537.2	698.1	364.4	215.3	101.5	85.4
CTnI(ng/ml)	0~0.034	0.630	0.424	0.258	0.126	0.096	0.059
NTproBNP(pg/ml)	0~125	>35000	22900	21000	9500	9000	8650

项目	正常范围	1 d	2 d	3 d	4 d	5 d	6 d
CKMB(ng/ml)	0~2.03	37.5	20.6	9.29	9.7	6.24	1.42
Myo(ng/ml)	0~61.5	537.2	698.1	364.4	215.3	101.5	85.4
CTnI(ng/ml)	0~0.034	0.630	0.424	0.258	0.126	0.096	0.059
NTproBNP(pg/ml)	0~125	>35000	22900	21000	9500	9000	8650

项目	正常范围	1 d	2 d	3 d	4 d	5 d	6 d
AST(U/L)	13~35	46	33	30	27	28	25
ALT(U/L)	7~40	268	178	176	130	91	54
TBI(μmol/L)	3.0~21.0	62.7	70.2	55.9	40.9	35.6	23.2
DBI(μmol/L)	0.0~7.0	44.6	49.8	39.2	27.7	22.9	15.3
IBIL(μmol/L)	3.0~14.0	18.1	20.4	16.7	13.2	12.7	7.9
CHE(U/L)	4000~13000	3598	3027	3491	3706	4047	4156
TP (g/L)	65~85	58	48	50	56	55	60
ALB (g/L)	40~55	32	27	31	33	35	34
TBA(μmol/L)	0.0~20.0	25.1	18.11	7.78	4.82	3.38	2.81

项目	正常范围	1 d	2 d	3 d	4 d	5 d	6 d
AST(U/L)	13~35	46	33	30	27	28	25
ALT(U/L)	7~40	268	178	176	130	91	54
TBI(μmol/L)	3.0~21.0	62.7	70.2	55.9	40.9	35.6	23.2
DBI(μmol/L)	0.0~7.0	44.6	49.8	39.2	27.7	22.9	15.3
IBIL(μmol/L)	3.0~14.0	18.1	20.4	16.7	13.2	12.7	7.9
CHE(U/L)	4000~13000	3598	3027	3491	3706	4047	4156
TP (g/L)	65~85	58	48	50	56	55	60
ALB (g/L)	40~55	32	27	31	33	35	34
TBA(μmol/L)	0.0~20.0	25.1	18.11	7.78	4.82	3.38	2.81

项目	正常范围	1 d	2 d	3 d	4 d	5 d	6 d
Urea(mmol/L)	2.5~6.1	53.33	23.9	12.8	7.5	6.8	2.9
Crea(μmol/L)	46~92	1033	551	309	235	171	93
UA(μmol/L)	149~466	756	386	323	85	45	30
CO₂CP(mmol/L)	22~30	11	16	24	27	29	26
尿量 (ml/24 h)		小于30 ml	405	550	1120	3050	2540