Effect of hemoperfusion combined with continuous veno-venous hemofiltration on acute paraquat poisoning:a Meta-analysis
10.3760/cma.j.issn.2095-4352.2018.08.014
- VernacularTitle:血液灌流联合连续静-静脉血液滤过对急性百草枯中毒疗效的Meta分析
- Author:
Chao LAN
1
;
Qing LYU
;
Hui PEI
;
Xing MENG
;
Qi LIU
;
Xinya JIA
;
Zhongshi LI
;
Chao WANG
;
Huaqing YE
;
Yijun FAN
Author Information
1. 郑州大学第一附属医院急诊ICU
- Keywords:
Acute paraquat poisoning;
Hemoperfusion;
Continuous veno-venous hemofiltration;
Hemopurification;
Meta-analysis
- From:
Chinese Critical Care Medicine
2018;30(8):783-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective To comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP).Methods Literatures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3. Results Twenty-one studies were included with 2222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77％ (362/827) vs. 55.26％ (604/1093), odds ratio (OR) =0.68, 95％ confidential interval (95％CI) = 0.56-0.82,P = 0.0001], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95％CI = 2.60-6.66,P < 0.00001], incidence of MODS [25.93％ (70/270) vs. 55.36％ (155/280),OR = 0.26, 95％CI = 0.14-0.49,P< 0.0001], and incidence of ARDS [30.37％ (82/270) vs. 51.07％(143/280),OR = 0.42, 95％CI = 0.30-0.61,P < 0.00001], and inefficiency rate [8.72％ (13/149) vs. 34.64％ (53/153),OR=0.17, 95％CI = 0.09-0.34, P < 0.00001] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies.Conclusion HP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.
