Published 2016-01-01
“…Objective Sepsis is a severe clinical disease,which seriously threatened patients’ survival.The fatality
rate in complicated acute kidney injury（AKI） cases is high,but the treatment of sepsis is still very difficult.There are reports that high volume hemofiltration（HVHF） has a certain effect on sepsis,which lacks of evidence-based medicine.We performed a retrospective analysis on HVHF in the treatment of sepsis with to evaluate the effect of HVHF on sepsis with AKI.Methods A retrospective analysis was made on 60 patients of sepsis with AKI receiving HVHF in our hospital from January 2014 to March 2015.There were 32 males and 28 females with age ranging from18 to 80 years old.All patients were given internal jugular vein or femoral venous indwelling needle to establish double lumen catheter vascular access using Baxter the Accura blood filter.The replacement of fluid input dose was >50 ml·kg<sup>-1</sup>·h<sup>-1</sup>,and blood flow was 200<sup>3</sup>00 ml/min.The ultrafiltration volume was decided according to central venous pressure,and daily turnover quantity.The changes of various indexes were observed before and 24,48 and 72 h after HVHF treatment,including body temperature,central venous pressure,mean arterial pressure,oxygen partial pressure,serum creatinine,blood urea nitrogen,potassium,phosphorus,serum calcium,hydrocarbonate,IL-6 and TNF-α.The survival of patients given HVHF at 28 th day after treatment was analyzed,the clinical outcome and prognosis observed,and the necessity of renal replacement therapy evaluated.The results were statistically analyzed using SPSS 17.0 package.Results Lung and alimentary tract were the frequent infection sites of sepsis patients.At 28 th day after HVHF,28 patients survived（47.67%）,26 patients died（42.33%） among 60 patients,and 6 patients needed sequent renal replacement therapy among the survivors.The average duration of treatment was（8.56 ± 5.32） days.The result showed that some indexes including body temperature,central venous pressure,mean arterial pressure,and oxygen partial pressure had no significant difference before and 24,48 and 72 h after HVHF（P>0.05）,but heart
rate,serum creatinine,blood urea nitrogen,potassium and phosphorus were significantly reduced after HVHF（P<0.05）,and the hydrocarbonate,and serum calcium were significantly increased after HVHF（P<0.05）.Conclusions HVHF can improve the systemic
state of sepsis patients with AKI,and can reduce the index of renal
function injury and improve the survival
rate of patients,so it is effective for sepsis in combination with AKI.…”
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