Plasma exchange combined continuous veno-venous hemo diafiltration in the treatment of critical hemolytic uremic syndrome
10.3760/cma.j.issn.1673-4912.2016.08.006
- VernacularTitle:血浆置换联合连续性血液净化治疗儿童重症溶血尿毒综合征
- Author:
Huijie MIAO
;
Yun CUI
;
Yucai ZHANG
;
Yan ZHU
;
Fei WANG
;
Rongxin CHEN
- Publication Type:Journal Article
- Keywords:
Plasma exchange;
Continuous veno-venous hemodiafiltration;
Hemolytic uremic syn-drome;
Critically ill;
Children
- From:
Chinese Pediatric Emergency Medicine
2016;23(8):531-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigta e the efficayc of bedside plasma exchange( PE) combined con-tinuous veno-venous hemodiafiltration ( CVVHDF ) in childer n with critical hemo lty ic uremic syndrome ( HUS) .Method s Eight patients with HUS from Pediatric Intensive Care Unit of Shanghai Ch ildren′s Hos-pitalw ere included in the present stuyd .The seveir ty of children was gar ded accordni g to peid atric critiac l ill-ness soc re and pediatric riks ofs core mortalityⅢ.Four of them received continuuo s blood purification treat-me nt.Meanwhile,the clinical manifestation and outcom e of HUS weer analyzed.Results Eight children with HUS weer ni itially trae ted with diuretic and blood transfusion for 12-24 hours.Four ac ses who deteriora-ted aggressively were ep rofr med PE and CVVHDF.Plasauto iQ21 and Prisma flex wereu sed with Pir sma TPE 2000 membrna e plasma separator and AN69 M60 membrane filter respectively.All the 4 patients with critical HUS survived after bedside continuous blood purification treatment.Clinical symptoms and serum bio-chemistry were improved sing ificantly as follows.The average levels of serum creatinine and lactate dehydro-genase decreased obviously(318μmol/L vs.162μmol/L;1 963 U/L vs.407 U/L,respectively).In addi-tion,platelet count increased significantly(40 ×109/L vs.97 ×109/L) .Eventually,symptoms disappeared in these 4 patients.Conclusion The combined therapy of PE and CVVHDF in HUS could stabilize fluid acid-base equilibrium,prevent hemolysis and improve the renal function.
