Effects of continuous veno-venous hemodiafiltration in patients with severe Kawasaki disease complicated with multiple organ dysfunction syndrome
10.3760/cma.j.issn.0578-1310.2018.09.011
- VernacularTitle: 连续性静脉-静脉血液透析滤过辅助治疗儿童重症川崎病合并多器官功能障碍综合征
- Author:
Fei WANG
1
;
Yun CUI
;
Chunxia WANG
;
Tingting XIAO
;
Rongxin CHEN
;
Yucai ZHANG
Author Information
1. Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Tiao Tong University, Shanghai 200062, China
- Publication Type:Clinical Trail
- Keywords:
Mucocutaneous lymph node syndrome;
Hemodiafiltration;
Multiple organ failure;
Child
- From:
Chinese Journal of Pediatrics
2018;56(9):691-694
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of continuous veno-venous hemodiafiltration (CVVHDF) as a rescue therapy in children with Kawasaki disease (KD) complicated with multiple organ dysfunction syndrome (MODS).
Methods:The medical records of 5 patients diagnosed as KD with MODS treated with CVVHDF, who were admitted to pediatric intensive care unit (PICU) of Shanghai Children's Hospital from November 2015 to October 2017 were retrospectively collected. The inflammatory factors and parameters of organ function before and after CVVHDF treatment were analyzed. Wilcoxon test was used to compare the changes of parameters before and after CVVHDF treatment.
Results:The pediatric critical illness score (PCIS) and the pediatric risk of score mortality score Ⅲ (PRISMⅢ) were 74.0 (70.0, 81.0) and 14.5 (12.5, 17.0), respectively. The duration of CVVHDF treatment was 46.0 (24.5, 48.0) h. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), blood lactic acid were significantly decreased after the CVVHDF treatment (0.4 (0.1, 28.8) vs. 142.0 (123.1, 1 454.6) ng/L, Z=-2.023, P=0.043; 0.1 (0.1, 9.3) vs. 1.7(1.1, 30.0) ng/L, Z=-2.023, P=0.043; 1.2(1.1,1.4) vs. 2.5(2.4, 2.7) mmol/L, Z=-2.041, P=0.041 respectively). Moreover, the lung, liver and kidney function were significantly improved as indicated by the ratio of PaO2 to FiO2 (380.0 (182.5, 397.5) vs. 160.0 (52.5, 185.0)mmHg (1 mmHg=0.133 kPa), Z=2.041, P=0.041), the level of total bilirubin ((14.9±1.3) vs. (86.4±9.9) μmol/L), and the levels of creatinine (2 cases: 24.0vs. 103.0 μmol/L, 38.0 vs. 142.0 μmol/L).
Conclusion:CVVHDF as an adjuvant therapy can rapidly reduce the levels of IL-6 and TNF-α,and improve the organ functions in children with KD complicated with MODS.
