Therapeutic effects of early continuous hemofiltration on severe sepsis

doi:10.3969/j.issn.1002-7386.2018.07.015

Abstract：Objective To evaluate the clinical curative effects of early continuous hemodilution on severe sepsis. Methods Sixty-three patients with severe sepsis were randomly divided into early hemofiltration group (n=32) and basal therapy group (n =31). The patients in basal therapy group were treated by conventional basic treatment,however,the patients in early hemofiltration treatment group,on the basis of basal therapy group,were treated by 24-hour continuous hemofiltration.The changes of PCT,CRP,IL-6,IL-10,hemodynamics indexes including heart rate, mean arterial pressure, oxygenation index and APACHE Ⅱ score before treatment and at 72 hours after treatment were observed and compared between two groups.Results After treatment there were no significant differences in inflammatory indexes except for IL-10 at 72 hours after treatment between two groups (P >0.05),however,the other indexes including PCT, CRP and IL-6 were significantly improved in both groups,as compared with those before treatment(P<0.05). The levels of PCT,CRP and IL-6 in early hemofiltration group were significantly lower than those in basal therapy group (P<0.05).Moreover the changes of hemodynamics indexes including heart rate,mean arterial pressure and oxygenation index were significantly improved in both groups,as compared with those before treatment (P<0.05),in which, there was significant difference in oxygenation index between two groups (P<0.05),which in early hemofiltration group was superior to that in basic treatment group.In addition the APACHE Ⅱ scores in early hematofilter group were significantly lower than those in basic treatment group (P<0.05). Conclusion The early continuous hemofiltration in treatment of severe sepsis can effectively remove inflammatory factors, improve the oxygenation function and stabilize the hemodynamics of the body.