著しいアルカレミアを呈したアルコール性肝硬変患者に対する血液浄化療法

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Apheresis therapy is known to be very effective in patients with acidemia.However, the therapy is not usually recommended for patients with alkalemia because arterial pH rises further with it.We encountered a 43-year-old patient with severe alkalemia with multiple organ failure.Because apheresis in this case caused worsening of the alkalemia,as anticipated,we used diafiltration fluid with reduced bicarbonate,intentionally suppressed respiration by using an artificial respirator and sedatives, and administered hydrochloric acid intravenously.With these modifications,apheresis therapy was successfully continued,and the patient eventually recovered. We conclude that these countermeasures for alkalemia are very useful in the apheresis treatment of patients with severe alkalemia.
信州医学会の論文