Efficacy analysis of high-flux hemofiltration in the treatment of sepsis
10.3760/cma.j.issn.1001-7097.2011.04.005
- VernacularTitle:高通量血液滤过治疗脓毒症的疗效分析
- Author:
Hongyun LV
;
Ping ZHANG
;
Jianghua CHEN
- Publication Type:Journal Article
- Keywords:
Hemofiltration,high-flux;
Sepsis;
Renal insufficiency.acute
- From:
Chinese Journal of Nephrology
2011;27(4):236-242
- CountryChina
- Language:Chinese
-
Abstract:
objective To analyze the risk factors of sepsis,and to elucidate the efficacy of high-flux hemofihration(HVHF)in the treatment of sepsis and the initiate opportunity of HVHF treatment on sepsis complicated with acute kidney injury(AKI). Methods Clinical data of 152patients with sepsis undergoing HVHF treatment were retrospectively analyzed.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ score evaluation before treatment and 24 h,48 h.72 h after treatment were performed.According to 28-day survival,patients were divided into survival group and death group.Clinical indicators before and 24 h,48 h,72 h after treatment were compared between groups.Risk factors influencing prognosis of patients were examined by multivariate regression analysis.Influence of AKI stages on prognosis of patients was studied. Resalts Lung and alimentary tract were the most frequent infection sites of sepsis.Twenty-eight days after HVHF treatment,74 patients (48.68%)survived,seventy-eight patients (51.32%)died among 152patients,and 4 patients(2.63%)needed sequent renal replacement therapy.Twenty-eight-day mortality was significantly lower than the mortality 88.78%±17.72%predicted by APACHE Ⅲ.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ Sscores decreased remarkably (P＜0.01) 24 hours after treatment.Age,number of dysfunctional organ,APACHE Ⅱ,APACHE Ⅲ,SAPS Ⅱ scores,undedying diseases,shock,AKI,severe acute pancreatitis,alimentary tract hemorrhage,cataphora and pressor agent were correlated with 28-d survival rate.Underlving diseases and APACHE Ⅲ were independent risk factors.Renal function recovery rate in AKI stage 1 was higher than that in AKI stage 2,3(P＜0.05).Twenty-eight-day mortality of patients without AKI was lower compared to AKI stage 1,2,3(P＜0.05),but 28-day mortality was not significantly different among AKI stage 1,2,3. Conclusions Prognosis of patients with sepsis is poor.HVHF can improve biochemical indicators and prognosis of patients effectively,and increase survival rate.Underlying diseases and APACHE Ⅲ are independent risk factors of 28-day mortality of sepsis patients.Twenty-eight-day mortality of non-AKI patients is obviously lower compared to AKI stage 1,2,3patients.AKI stage is correlated with 28-day renal function recovery rate,but not obviously correlated with 28-day mortality.
