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Preparation method and application of blood filtration displacement liquid containing organic phosphate

An organic phosphate and blood filtration technology, applied in the field of medical pharmacology, can solve the problems of fixed phosphate concentration and inability to adjust the blood phosphorus level of patients, and achieve the effect of reducing the incidence.

Pending Publication Date: 2022-08-05
NANJING GENERAL HOSPITAL NANJING MILLITARY COMMAND P L A
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Because the phosphate concentration of the finished phosphorus-containing replacement fluid is fixed, it cannot be adjusted in time according to the patient's blood phosphorus level

Method used

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  • Preparation method and application of blood filtration displacement liquid containing organic phosphate
  • Preparation method and application of blood filtration displacement liquid containing organic phosphate

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specific Embodiment 1

[0018] At present, the replacement fluid used in China does not contain phosphorus. The problem of hypophosphatemia during CRRT treatment has attracted more and more attention, and some studies have found that hypophosphatemia is negatively correlated with prognosis. Plasma phosphorus concentration is 1.0-1.5mmol / L, but due to the combination of some phosphorus and plasma proteins to form complexes, the phosphorus concentration in filterable ionic state is actually 0.9-1.0mmol / L, so the recommended replacement fluid phosphorus concentration is 0.7 -1.0mmol / L. The replacement fluid phosphorus concentration of 1.0mmol / L may be more suitable for clinical practice.

[0019] When 4ml of sodium glycerophosphate is added to 4L of replacement solution, the phosphorus concentration is 1.0mmol / L;

[0020] When 3ml of sodium glycerophosphate is added to 4L of replacement solution, the phosphorus concentration is 0.75mmol / L;

[0021] When 2ml of sodium glycerophosphate is added to 4L of...

specific Embodiment 2

[0028] In the clinical case: a 94-year-old male patient with underlying type 2 diabetes mellitus, hypertension, diabetic retinopathy, peripheral neuropathy, urinary bladder retention, and diabetic nephropathy.

[0029] During hospitalization, the patient suffered from aspiration pneumonia due to repeated eating and coughing. He was connected to a ventilator to assist breathing, nasogastric feeding of enteral nutrition, decreased urine output, and progressively increased serum creatinine. Intermittent bedside continuous blood purification treatment ( CRRT).

[0030] Monitor blood phosphorus to 0.55mmol / L. After intravenous supplementation of phosphate preparations, blood phosphorus fluctuates rapidly in a short time, and iatrogenic hyperphosphatemia occurs. The highest blood phosphorus rises to 2.11mmol / L. down to 0.62mmol / L;

[0031] 4ml of sodium glycerophosphate was added to 4L of replacement fluid to prepare a phosphorus-containing replacement fluid with a phosphorus conce...

specific Embodiment 3

[0032]In the clinical case: female patient, 42 years old, underwent laparoscopic exploration + radical resection of sigmoid colon cancer on 2022.02.05, fecal fluid flowed out of abdominal drainage tube on the second day after operation, and underwent colostomy + peritoneal irrigation and drainage on 2022.02.07, Abdominal infection, septic shock, acute kidney injury, acute respiratory distress syndrome, tracheal intubation connected to ventilator-assisted breathing, continuous CRRT treatment, application of phosphorus-free replacement fluid treatment.

[0033] Because the patient could not take enteral nutrition, daily parenteral nutrition supplemented with phosphate (sodium glycerophosphate injection 10ml / day), but the blood phosphorus remained low. Serum phosphorus remained within the normal range after sodium-based replacement fluid containing phosphorus.

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Abstract

The invention provides a preparation method and application of a blood filtration displacement liquid containing organic phosphate. Sodium glycerophosphate is used as organic phosphate and has good mixing compatibility with a calcium-containing solution, and a sodium glycerophosphate injection is clinically used as an intravenous nutrition additive or a component of a mixed electrolyte solution. Sodium glycerophosphate is catalyzed by alkaline phosphatase in vivo and hydrolyzed into inorganic phosphate and glycerol which are metabolized and utilized by the organism. The sodium glycerophosphate injection can be used as a source of phosphorus-containing displacement liquid phosphate. The plasma phosphorus concentration is 1.0-1.5 mmol / L, but due to the fact that part of phosphorus is combined with plasma protein to form a compound, the filterable ionic state phosphorus concentration is actually 0.9-1.0 mmol / L. Therefore, in 2021, the replacement liquid with the phosphorus concentration being 0.7-1.0 mmol / L and the phosphorus concentration being 1.0 mmol / L recommended by China Standard Operation Regulations for Blood Purification can effectively prevent and treat the CRRT critical symptom hypophosphatemia, and the replacement liquid with the phosphorus concentration being 0.7-1.0 mmol / L and the phosphorus concentration being 1.0 mmol / L can be used for preventing and treating the CRRT critical symptom hypophosphatemia. Meanwhile, iatrogenic hyperphosphatemia is avoided as far as possible.

Description

technical field [0001] The invention relates to the field of medical pharmacology, in particular to a preparation method and application of an organophosphate-containing blood filtration replacement fluid. Background technique [0002] Phosphorus is an important constituent element of the human body and has important physiological functions. Intracellular phosphorus is involved in the replication and expression of genetic information, carbohydrate, lipid, protein and energy metabolism, as well as enzymatic reactions, and maintains cell membrane function and metabolic regulation; while extracellular phosphorus (blood phosphorus) acts as a phosphate buffer system to maintain acid-base It plays an important role in balance and is also a source of intracellular phosphorus and phosphate required for bone mineralization. Serum phosphate is the inorganic phosphate in plasma, mainly as HPO 4 2- and H 2 PO 4 - form exists. Normal blood phosphorus concentration is 0.7-1.5 mmol / ...

Claims

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Application Information

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IPC IPC(8): A61K31/661A61K9/08A61P3/12A61P7/08
CPCA61K31/661A61K9/08A61K9/0026A61P7/08A61P3/12
Inventor 董建华葛永纯张明红黄丽璇孔凌
Owner NANJING GENERAL HOSPITAL NANJING MILLITARY COMMAND P L A
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