Targeted Emergency Management Model and Its Impact on Cardiac and Renal Function in Maintenance Hemodialysis Patients Complicated with Acute Severe Myocarditis

ZOU Yan; DENG Kaihui; LUO Haili; LIANG Caixia

doi:10.13919/j.issn.2095-6274.ZHJY202510005

Abstract：Objective To investigate the application effect of a targeted emergency management model in the emergency treatment of maintenance hemodialysis(MHD)patients complicated with acute severe myocardi-tis.Methods Seventy-six MHD patients complicated with acute severe myocarditis admitted to our hospital from March 2023 to March 2025 were selected as the study subjects.They were randomly divided into an obser-vation group and a control group using a random number table,with 38 patients in each group.The control group received conventional emergency measures,while the observation group received the targeted emergency manage-ment model based on conventional measures.This model included intensified electrocardiographic monitoring,pre-cise volume management,timely application of continuous renal replacement therapy(CRRT),immunomodulation,and individualized nutritional support.The incidence of arrhythmias,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],myocardial enzyme profiles[creatine kinase-MB(CK-MB),cardiac troponin I(cTnI),lactate dehydro-genase(LDH)],renal function indicators[serum cre-atinine(Scr),blood urea nitrogen(BUN),endogenous creatinine clearance rate(Ccr)],and the total clinical effectiveness rate were compared between the two groups after treatment.Results After treatment,the incidence of arrhythmias in the observation group(18.42%)was significantly lower than that in the control group(39.47%),and the difference was statistically significant(P<0.05).The improvement in cardiac function was more pronounced in the observation group,with LVEF significantly higher than that in the control group,and LVEDD and LVESD significantly lower than those in the control group(all P<0.001).Meanwhile,the improvement ampli-tudes in myocardial enzyme profiles(CK-MB,cTnI,LDH)and renal function indicators(Scr,BUN,Ccr)in the ob-servation group were significantly superior to those in the control group(all P<0.001).The total clinical effective-ness rate in the observation group was significantly higher than that in the control group(81.58%vs.60.52%,P<0.05).Conclusion In the emergency treatment of MHD patients complicated with acute severe myocarditis,the application of the targeted emergency management model can effectively reduce the risk of arrhythmias,significant-ly improve cardiac and renal function,alleviate myocardial injury,and enhance the success rate of clinical rescue.