Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis

Objective To observe the clinical efficacy and safety of hemoperfusion(HP) therapy combined with continuous venovenous hemofiltration(CVVH) for patients with sepsis.Methods A total of 70 ICU patients meeting the sepsis criteria was selected to divide into two groups(group A and B,35 patients for eac...

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Main Authors: LUO Jian-yu, WANG Xiao-yuan, LV Guang-yu, CAI Tian-bin
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2019-01-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/thesisDetails?columnId=57913579&Fpath=home&index=0
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author LUO Jian-yu
WANG Xiao-yuan
LV Guang-yu
CAI Tian-bin
author_facet LUO Jian-yu
WANG Xiao-yuan
LV Guang-yu
CAI Tian-bin
author_sort LUO Jian-yu
collection DOAJ
description Objective To observe the clinical efficacy and safety of hemoperfusion(HP) therapy combined with continuous venovenous hemofiltration(CVVH) for patients with sepsis.Methods A total of 70 ICU patients meeting the sepsis criteria was selected to divide into two groups(group A and B,35 patients for each group) based on the random number table method.The patients in group A were treated in combination with CVVH on the basis of the medical treatment,and the ones in group B received combination of HP with CVVH on the basis of the medical treatment.Results In group A,the hypersensitivity C-reactive protein(hs-CRP),tumor necrosis factor a(TNF-a),interleukin 6(IL-6) and calcitonin protoxin(PCT) and lipopolysaccharide(LPS) decreased in at 120 h of treatment(P<0.05).In group B,the above indexes decreased at 72 h and 12 h of treatment,and the decrease for group A was more significant than that for group A(P<0.05).The mean arterial pressure(MAP) was improved in the two groups(P<0.05) at 120 h of treatment,but there was no significant difference between the two groups(P>0.05).In group B,at 120 h of treatment,heart rate(HR),vasoactive-inotropic score(VIS),oxygenation index(OI),acute physiology and chronic health evaluation(APACHE II) score and sequential organ failure assessment score(SOFA) were all decreased(P<0.05),and the decrease for group B was more significant than for group A(P<0.05).After treatment,the levels of blood serum creatinine(Scr) and total bilirubin(TBIL) decreased in both groups(P< 0.05),but there was no significant difference between the two groups at the same time point.There was no significant difference in blood purification time,incidence of serious bleeding events and 28-day mortality rate between the two groups(P>0.05);and,ICU hospitalization time and mechanical ventilation time in group B were shorter than those in group A(P<0.05),and ICU mortality rate in group B was smaller than that in group A(P<0.05).Conclusions Compared to alone CVVH,HP therapy combined with CVVH for patients with sepsis can remove inflammatory mediators more effectively and improve organ functions and prognosis,with no significant increase in incidence of the complication of bleeding.
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spelling doaj-art-70b4e05d4290411ca08751cd766faba62025-08-20T02:28:45ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902019-01-0115716157913579Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsisLUO Jian-yuWANG Xiao-yuanLV Guang-yuCAI Tian-binObjective To observe the clinical efficacy and safety of hemoperfusion(HP) therapy combined with continuous venovenous hemofiltration(CVVH) for patients with sepsis.Methods A total of 70 ICU patients meeting the sepsis criteria was selected to divide into two groups(group A and B,35 patients for each group) based on the random number table method.The patients in group A were treated in combination with CVVH on the basis of the medical treatment,and the ones in group B received combination of HP with CVVH on the basis of the medical treatment.Results In group A,the hypersensitivity C-reactive protein(hs-CRP),tumor necrosis factor a(TNF-a),interleukin 6(IL-6) and calcitonin protoxin(PCT) and lipopolysaccharide(LPS) decreased in at 120 h of treatment(P<0.05).In group B,the above indexes decreased at 72 h and 12 h of treatment,and the decrease for group A was more significant than that for group A(P<0.05).The mean arterial pressure(MAP) was improved in the two groups(P<0.05) at 120 h of treatment,but there was no significant difference between the two groups(P>0.05).In group B,at 120 h of treatment,heart rate(HR),vasoactive-inotropic score(VIS),oxygenation index(OI),acute physiology and chronic health evaluation(APACHE II) score and sequential organ failure assessment score(SOFA) were all decreased(P<0.05),and the decrease for group B was more significant than for group A(P<0.05).After treatment,the levels of blood serum creatinine(Scr) and total bilirubin(TBIL) decreased in both groups(P< 0.05),but there was no significant difference between the two groups at the same time point.There was no significant difference in blood purification time,incidence of serious bleeding events and 28-day mortality rate between the two groups(P>0.05);and,ICU hospitalization time and mechanical ventilation time in group B were shorter than those in group A(P<0.05),and ICU mortality rate in group B was smaller than that in group A(P<0.05).Conclusions Compared to alone CVVH,HP therapy combined with CVVH for patients with sepsis can remove inflammatory mediators more effectively and improve organ functions and prognosis,with no significant increase in incidence of the complication of bleeding.http://www.lcszb.com/thesisDetails?columnId=57913579&Fpath=home&index=0HemoperfusionContinuous venovenous hemofiltrationSepsis
spellingShingle LUO Jian-yu
WANG Xiao-yuan
LV Guang-yu
CAI Tian-bin
Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
Linchuang shenzangbing zazhi
Hemoperfusion
Continuous venovenous hemofiltration
Sepsis
title Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
title_full Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
title_fullStr Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
title_full_unstemmed Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
title_short Clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
title_sort clinical application of hemoperfusion therapy combined with continuous venovenous hemofiltration in patients with sepsis
topic Hemoperfusion
Continuous venovenous hemofiltration
Sepsis
url http://www.lcszb.com/thesisDetails?columnId=57913579&Fpath=home&index=0
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AT lvguangyu clinicalapplicationofhemoperfusiontherapycombinedwithcontinuousvenovenoushemofiltrationinpatientswithsepsis
AT caitianbin clinicalapplicationofhemoperfusiontherapycombinedwithcontinuousvenovenoushemofiltrationinpatientswithsepsis