Sodium-reduced continuous venovenous hemodiafiltration (CVVHDF) for the prevention of central pontine myelinolysis (CPM) in hyponatremic patients scheduled for orthotopic liver transplantation.

Abstract

Two patients in end-stage hepatic failure presented for orthotopic liver transplantation with longstanding severe hyponatremia (121 and 122 mmol/L). Both patients underwent liver transplantation with the concomitant use of continuous venovenous hemodiafiltration. Replacement and dialysate solutions were prepared individually to contain a sodium level that was individually considered safe with regard to the development of central pontine myelinolysis. The sodium increase in both patients was within the expected and planned limits despite a situation of mass transfusion. Both patients did well postoperatively and neither patient suffered neurological deficits.

• Authors: Marcus R Lenk, Michael Kaspar
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 24 Issue 5 Pg. 407-11 (Aug 2012) ISSN: 1873-4529 [Electronic] United States
• PMID: 22658371 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Hemodialysis Solutions
• Sodium

Topics

• End Stage Liver Disease (surgery)
• Hemodiafiltration (methods)
• Hemodialysis Solutions (chemistry)
• Humans
• Hyponatremia (complications)
• Liver Transplantation
• Male
• Middle Aged
• Myelinolysis, Central Pontine (prevention & control)
• Sodium (administration & dosage)