Heparin-free hemodialysis in the treatment of hypernatremia in severely burned patients

Background: Hypernatremia in severely burned patients is associated with hi gh morbidity and mortality rates. As the causes of hypernatremia in major b urn patients are still not clear, hemodialysis is the method of choice for the treatment. While hemodialysis is effective for the control of hypernatr emia, it can cause bleeding complications that may be fatal for burn patien ts with extensive wounds and potential gastro-intestinal mucosal damage. Clinical data: In the present study heparin-free hemodialysis in which the heparin is firmly absorbed to the haemofiltration membrane. hemophan, dispe nsed with systemic use of heparin. In two extensively burned patients with burn area of 100% TBSA and 98% TBSA respectively and hypernatremia with ser um sodium concentration as high as 169 and 158 mmol/l respectively, heparin -free hemodialysis was performed five times and three times each. Results: Hypernatremia was satisfactorily corrected with no interference to the coagulation system in the two patients as indicated by clinical observ ation and biochemical analysis. Thr patient with burn area of 98% TBSA surv ived and the patient with burn area of 100% TBSA died of wound coverage fai lure 6 weeks after injury because of non-availability of autograft. Conclusion: Heparin-free hemodialysis is an effective and safe method in th e treatment of hypernatremia in extensively burned patients. (C) 2000 Elsev ier Science Ltd and ISBI. All rights reserved.