Study on the Efficacy of Lung Recruitment and Continuous Renal Replacement Therapy in Elderly Patients with Sepsis and Respiratory Failure

doi:10.3969/j.issn.1004-5775.2025.16.004

Abstract：Objective: To investigate the effect of lung recruitment combined with continuous renal replacement therapy (CRRT) on elderly patients with sepsis and respiratory failure (RF). Methods: A retrospective analysis was conducted on the medical records of 70 elderly patients with sepsis and RF admitted to the First People's Hospital of Jiujiang City from January 2022 to December 2023. Patients were divided into two groups based on the treatment regimen: the control group (basic treatment + lung recruitment, 35 cases) and the study group (basic treatment + lung recruitment + CRRT, 35 cases). The levels of inflammatory factors, respiratory mechanics parameters, blood gas indicators, and adverse reactions were compared between the two groups. Results: After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), procalcitonin (PCT), and white blood cell count (WBC) in the study group were lower than those in the control group, with statistically significant differences (t=6.871, 10.536, 9.537, 3.869, P<0.001). After treatment, the airway resistance (Raw) and airway plateau pressure (Pplat) in the study group were lower than those in the control group, while tidal volume (TV) and respiratory system static compliance (Cst) were higher, with statistically significant differences (t=5.009, 5.301, 2.885, 3.460, P<0.05). After treatment, the partial pressure of oxygen (PO2) and oxygenation index (OI) in the study group were higher than those in the control group, while the partial pressure of carbon dioxide (PCO2) was lower, with statistically significant differences (t=3.486, 8.866, 2.683, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ2=1.148, P>0.05). Conclusion: Providing lung recruitment combined with CRRT intervention for elderly patients with sepsis and RF can promote the rapid resolution of inflammation, regulate respiratory function, improve blood gas status, and has a high level of safety.