Objective To analyze and summarize the and charcteristics and processing methods of critical value in renal transplantation recipients during perioperative period.
Methods Clinical data including gender, age, critical value, primary disease, clinical diagnosis and corresponding management at the presence of critical value in 273 cases with renal transplantation were collected and analyzed during perioperative period.
Results and conclusions During perioperative period, the critical values of water, electrolyte and acid-base disorders were observed in 43.2% (118/273) of renal transplantation cases. The hyperpotassemia was found in 24.9% (68/273) of cases, which was the most common critical value. The percentage of male patients presenting with critical value was 76.9%, significantly higher compared with 23.1% in female counterparts, especially in those aged 35 to 54 years. For patients with critical value of hyperpotassemia, calcium gluconate or calcium chloride was administered to stabilize myocardium cell membrane. Insulin, glucose and sodium bicarbonate were administered via intravenous drip to accelerate intracellular transportation of K+ and diuretics were used to promote the excretion of K+. Hemodialysis therapy was used if the treatment is ineffective. The serum level of potassium restored to normal range after treatment in all cases. For those presenting with critical values of other parameters, individualized treatment was adopted based upon different conditions. Understanding of common critical values during perioperative period, characteristics and causes of distribution of critical values in renal transplant recipients of different age and gender offers guidance for clinical monitoring and treatment.
DownLoad: