Twenty eight patients with multiple organ dysfunction syndrome (MODS) underwent continuous venovenous hemofiltration (CVVH)in ICU from June 2003 to June 2008, including 13 cases treated with predilution mode and 15 with postdilution mode. The changes of oxygenate index( PaO2/FiO2 )during CVVH were retrospectively analyzed. The total case fatality rate of this group of patients was 46%(13/28). There was a significant increase in PaO2/FiO2 of 28 cases during the first 48 h of CVVH (P ＜0. 05);the levels of PaO2/FiO2 in predilution group had increased significantly within 48 h during CVVH (P＜0. 05), while those in postdilution group had not significantly changed (P ＞ 0. 05). There was a significant increase in Pa02/FiO2 for the survival patients during the first 48h CVVH( P ＜ 0. 05 ), while no significantly change in the fatal cases(P ＞0. 05 ). In summary, oxygenate function and outcome of patients with MODS can be improved by CVVH, and predilution may be a more effective mode.

Objective To evaluate the effect of red light irradiation on serum phosphorus reduction in hemodialysis.Methods Sixty maintenance hemodialysis patients were divided into treatment group and control group.During the hemodialysis,the blood in the extracorporeal circulation tube of the patents in the treatment group was irradiated with red light by a MRX-1 red light therapy system.The irradiation was continued for 60 minutes each time,and one course of the treatment contained 10 times of irradiations.Patients in the control group were subjected to hemodialysis by conventional methods.The serum phosphate levels of all patients were measured before and after the treatment.Results The symptoms of dialysis disequilibrium of the patients in the treatment group were alleviated.There was no significant difference in serum phosphate levels between the treatment group and the control group before hemodialysis,while a statistically significant difference was found after the treatment (P＜0.05).Conclusions Hemodialysis combined with red light irradiation on external blood trails can contribute to the decrease of serum phosphate levels in maintenance hemodialysis patients.

Objective To determine the risk factors of Contrast-induced Nephropathy(CIN)and discuss means of minimizing the risk or preventing this complication.Methods A retrospective analysis of the data of 17 patients who were confirmed CIN in The Second Affiliated Hospital of Guzngzhou Medical College from 2004.6-2005.12 was admin- istrated.The contrast medium was lopamidol,doses varied from 70 mL to 150 mL.Serum creatinine(Scr)was meas- ured before and day 2,day 7 after angiography.Results Scr elevation of all the patients was 82.35?99.10?mol/Lat day 2.Scr of 11 patients returned to normal at day 7(103.82?20.49)?mol/L,the other 6 still remain high level (437.83?335.85)?mol/L and 3 of them needed hemodialysis therapy.Conclusion Risk factors of CIN include baseline Scr elevation,congestive heart failure,diabetes,high doses of contrast medium and concomitant use of nephro- toxic drugs.Contrast medium should be used at the minimal dose necessary in patients preexisting renal impairment.Di- uretics and other nephrotoxic drugs should be withheld for at least 24 hours before and after exposure to contrast medium. Additional fluids and hemofiltration should be given to prevent CIN.