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Clinical Evaluation of High-Volume Hemofiltration with Hemoperfusion Followed by
Intermittent Hemodialysis in the Treatment of Acute Wasp Stings Complicated by
Multiple Organ Dysfunction Syndrome
#MMPMID26207371
Si X
; Li J
; Bi X
; Wu L
; Wu X
PLoS One
2015[]; 10
(7
): e0132708
PMID26207371
show ga
Multiple organ dysfunction syndrome (MODS) is a rare complication of wasp stings.
Currently, there is no standardized treatment for MODS secondary to multiple wasp
stings, although blood purification techniques are often used. This study aimed
to analyze our experiences of using intermittent hemodialysis (IHD) with or
without high-volume hemofiltration (HVHF) for treating acute wasp stings
complicated by MODS. In this retrospective study, 36 patients with wasp stings
complicated by MODS received either IHD combined with hemoperfusion, or HVHF
(ultrafiltration flow rate, 70 mL/kg/h) combined with hemoperfusion for 5 days
followed by IHD. Clinical symptoms, blood biochemical parameters, duration of
mechanical ventilation, use of vasoactive agents, duration of hospital stay and
survival rate were recorded, and Acute Physiology and Chronic Health Evaluation
II (APACHE II) and multiple organ dysfunction (MOD) scores estimated. Patients
treated with HVHF followed by IHD appeared to exhibit a faster recovery than
those receiving IHD alone, as evidenced by superior improvements in MOD
(4.29±1.08 vs. 2.27±1.07) and APACHE II (7.09±2.62 vs. 4.20±1.69) scores (P <
0.05). Patients treated with HVHF had significantly lower myoglobin, creatine
kinase-MB, lactate dehydrogenase, bilirubin and creatinine levels than patients
treated with IHD alone. In addition, the durations of hospital stay (13.15±2.77
vs. 27.92±3.18 days), vasopressor use (1.76±0.24 vs. 3.43 ± 1.01 days),
mechanical ventilation (3.02±1.63 vs. 5.94 ± 2.11 days) and oliguria (6.57±2.45
vs. 15.29 ± 3.51 days) were reduced, and renal function more often recovered
(85.1% vs. 53.1%), in the HVHF group compared with the IHD group (P < 0.05).
These results raise the possibility that HVHF plus IHD may be superior to IHD
alone for the treatment of acute wasp stings complicated by MODS; additional
prospective studies are merited to explore this further.
|Adult
[MESH]
|Animals
[MESH]
|Combined Modality Therapy/methods
[MESH]
|Female
[MESH]
|Hemofiltration/*methods
[MESH]
|Hemoperfusion/*methods
[MESH]
|Humans
[MESH]
|Insect Bites and Stings/complications/*therapy
[MESH]
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