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2014 ; 2
(3
): 125-9
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Evaluation of optimized continuous venovenous hemodiafiltration therapy
efficiency in severe burn patients with sepsis
#MMPMID27602373
Xu C
; Fan K
; Xie L
; Chen W
; Wang L
Burns Trauma
2014[]; 2
(3
): 125-9
PMID27602373
show ga
As an initial factor, sepsis and multiple organ dysfunction syndrome (MODS)
caused by sepsis are the principal causes of death in burned patients. In this
report, we measured the levels of tumor necrosis factor (TNF)-?, interleukin
(IL)-6 and IL-8 in severely burned patients with sepsis after the initiation of
continuous vein-vein hemodiafiltration (CVVHDF) to evaluate the clinical
usefulness of CVVHDF on the removal of key mediators. The vital sign indices,
such as the heart rate (HR), respiration (R) and central venous pressure (CVP),
were recorded at 0 and 42 h in each group. Further, the laboratory examinations
indexes, such as the white blood cell count, blood sugar, serum sodium, blood
urea nitrogen and serum creatinine, were detected in venous blood samples.
Twenty-two severely burned patients suffering from sepsis were randomized into
the control group (A, n = 11) and the experimental group (B, n = 11). The
patients in group A underwent conventional treatment, and those in group B
received conventional+CVVHDF treatment. The vital signs, such as the HR, R, and
CVP, and laboratory examination indices, such as the blood cell count, blood
sugar, serum sodium, blood urea nitrogen, and serum creatinine, dropped
significantly in group B compared with those in group A at 42 h (P < 0.05). The
plasma levels of TNF-?, IL-6 and IL-8 were measured at 0, 12, 18, 24, 36 and 42 h
after the start of CVVHDF and at the same time points after the patients were
diagnosed with sepsis in group A. The plasma levels of TNF-? in group B decreased
by 32% at 18 h after the start of CVVHDF and decreased by 43% at 42 h after the
start of CVVHDF; however, these levels were increased compared with the normal
values (P < 0.01). The plasma levels of IL-6 decreased at 18 h after the start of
CVVHDF (0.274 ± 0.137 ng/ml). Following a brief increase at 24 h, the plasma
levels of IL-6 again decreased continuously until the end of the investigation
(0.192 ± 0.119 ng/ml). The plasma levels of IL-8 in group B decreased by 56% at
18 h after the start of CVVHDF, but they were increased compared with the normal
values (P < 0.01). The plasma levels of IL-8 in group B decreased by 70% at 42 h
after the start of CVVHDF, but they were increased compared with the normal
values (P < 0.01). The MODS incident was 4 of 11 in group A compared with 1 of 11
in group B (P < 0.01). In conclusion, CVVHDF can effectively reduce the levels of
TNF-?, IL-6 and IL-8 as well as the MODS incidence in patients with serious
burns.