Wu Yanyan,Zhao Jinchuan,Lu Li.Therapeutic efficiency of continuous high-volume hemofiltration in patients with sepsis and severe acute respiratory distress syndrome[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(17):1782-1786.
Wu Yanyan,Zhao Jinchuan,Lu Li.Therapeutic efficiency of continuous high-volume hemofiltration in patients with sepsis and severe acute respiratory distress syndrome[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(17):1782-1786.DOI:
Therapeutic efficiency of continuous high-volume hemofiltration in patients with sepsis and severe acute respiratory distress syndrome
)等呼吸功能指标以及血流动力学参数如心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)的变化;检测治疗前及治疗后6、24、48、72 h白介素6(IL-6)、C反应蛋白(CRP)的变化;并观察机械通气的持续时间、住ICU时间、撤机成功率、28 d存活率。 结果 两组治疗后血流动力学指标HR、MAP、CVP较治疗前均有明显改善(P0.05),两组间没有显著差异(P0.05)。血滤组的24 h PaO
Objective To investigate the efficacy of continuous high-volume hemofiltration (CHVHF) in patients with sepsis and severe acute respiratory distress syndrome (ARDS). Methods A retrospective study was conducted on a total of 117 patients with sepsis and severe ARDS
who were admitted to our intensive care unit (ICU) from January 2008 to December 2014. They were divided into a control group (n=49) and a treatment group (n=68). The patients in the treatment group were treated with CHVHF and routine treatments
while the patients in the control group received routine treatments only. The oxygenation index (PaO
2
/FiO
2
)
extravascular lung water index (EVLWI)
arterial partial pressure of carbon dioxide (PaCO
2
)
heart rate (HR)
mean arterial pressure (MAP)
central venous pressure (CVP)
interleukin-6 (IL-6)
and C-reactive protein (CRP) were compared between the control group and the treatment group before treatment and at 6
24
48
and 72 h after treatment. The duration of mechanical ventilation (MV)
ICU stay time
percentage of weaning from MV
and 28-day survival rate were observed. Results The indexes of pulmonary function in the 2 groups were improved after treatment. Along with the treatment time increase
PaO
2
/FiO
2
was elevated while EVLWI and PaCO
2
were lowered
and the improvements were more significant in the treatment group than in the control group (24 h PaO
2
/FiO
2
: 122.4±9.6 vs 91.2±12.5 mmHg; 24 h EVLWI: 10.6±2.5 vs 12.8±2.6 mL/kg; 24 h PaCO
2
: 46.7±6.2 vs 50.8±4.4 mmHg
P0.05). HR
MAP and CVP were also improved after treatment (P0.05)
but there was no significant difference between the 2 groups (P0.05). Compared with the control group
6 h IL-6 and CRP levels were lower in the treatment group (IL-6: 51.61±6.09 vs 61.31±2.90 pg/mL; CRP: 22.97±4.24 vs 31.37±5.81 mg/L
P0.05). Compared with the control group
the duration
of MV and ICU stay time were shorter in the treatment group (duration of MV: 11.5±4.3 vs 20.6±7.4; ICU stay time: 19.5±9.2 vs 35.0±6.3
P0.05)
and the percentage of successful weaning from MV and 28-day survival rate were higher (percentage of successful weaning from MV: 89.7% vs 61.2%; 28-day survival rate: 83.8% vs 63.3%
P0.05). Conclusion CHVHF is an effective adjuvant treatment for severe ARDS through improving the lung function
shortening the duration of MV
improving the percentage of successful weaning from MV and the survival rate
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Related Institution
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