Continuous renal replacement therapy is efficient for patients with acute hypernatremia following severe craniocerebral injury and cerebral encephalorrhagia

Continuous renal replacement therapy (CRRT) has been widely employed in the treatment of critically ill patients. This study aimed to compare the efficacy of CRRT such as continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodiafiltration (CVVHDF), in patients with acute hypernatremia following craniocerebral injury and cerebral encephalorrhagia. Seventy-six patients with acute hypernatremia were treated with CRRT by GAMBO blood purification system in five different modes, CVVHD, CVVH with preoperative dilution, CVVH with postoperative dilution, CVVHDF with preoperative dilution, and CVVHDF with postoperative dilution. With the increase of dialysis buffer flow rate, serum sodium clearance rate and creatinine clearance rate were significantly elevated in all CRRT groups. The peak of clearance rate was achieved in patients treated with CVVH with preoperative dilution or CVVHDF with preoperative dilution, with flow rate set as 3,500 mL/h. The clearance rates were higher in CVVHDF group and the cycle rates of dialysis buffer were higher in CVVHD group than in other groups. All types of CRRT increased the survival of patients and the prognosis of patients in CVVHDF group was better than in other CRRT groups (P<0.05). In conclusion, CRRT efficiently and safely decrease serum sodium level and improve the prognosis of patients with acute hypernatremia following severe craniocerebral injury and cerebral encephalorrhagia.