Effect of early continuous renal replacement therapy on patients with severe sepsis
10.3969/j.issn.1008-9691.2014.01.013
- VernacularTitle:早期连续性肾脏替代治疗对严重脓毒症患者的治疗意义
- Author:
Qinhan LIN
;
Ming ZHANG
;
Jun CHEN
;
Haibo ZHOU
;
Guodong HUANG
- Publication Type:Journal Article
- Keywords:
Severe sepsis;
Continuous renal replacement therapy;
Acute kidney injury
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2014;(1):46-49
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of early continuous renal replacement therapy(CRRT)on patients with acute kidney injury(AKI)induced by severe sepsis. Methods A prospective study was conducted. 160 patients with AKI induced by severe sepsis admitted to intensive care unit(ICU)of Qingyuan People's Hospital between October 2009 and June 2013 were enrolled. According to the starting time of CRRT,the patients were randomly divided into two groups:an earl y treatment group and a regular treatment group(each,80 cases). All patients were treated in accordance with the principle of the cluster of severe sepsis. In early treatment group,the patents began to receive CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment over 6 hours,but the curative effect was not ideal. In the regular treatment group,the patients began to apply CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment persistently over 24 hours or difficultly corrected acidosis or heart failure developed. The changes in urine output,creatinine,saturation of blood oxygen,and albumin,and 28-day survival rate,length of ICU stay,time of organ support were measured and compared between the two groups to evaluate the therapeutic significance of the early CRRT. Results The mean length of ICU stay(day:6.5±1.7 vs. 8.2±1.6),length of organ support(day:5.3±1.8 vs. 6.0±1.4),the recovery time of urine amount(day:3.4±0.9 vs. 4.8±0.5)in early treatment group were significantly shorter than those in regular treatment group(all P<0.01);recovery ratio of urine in 1 week in early treatment group was significantly higher than that in regular treatment group(46.2%vs. 28.8%,P<0.05). The creatinine recovery ratio in 1 week in early treatment group was lower than that in regular treatment group(55.0%vs 78.8%),but there was no statistically significant difference(P>0.05). Early treatment group and regular treatment groups of creatinine recovery time were similar(day:5.1±1.3 vs. 5.2±1.2). 28-day survival rate in early treatment group was higher than that in regular treatment group(41.2%vs. 35.0%),but there was no statistically significant difference(P>0.05). Conclusion It is found that there is no evidence to suggest that early CRRT may improve the prognosis of the patients with AKI induced by severe sepsis,but it may be in favor of shortening the time of urine recovery,length of stay in ICU,length of organ support and length of dialysis.
