ABSTRACT
Objective: To study the efficacy and safety of sustained low-efficiency diafiltration (SLEDf) versus hemodialysis (HD) for patients with wasp stings who developed stage III acute kidney injury (AKI). Methods: We retrospectively analyzed the clinical data of consecutive patients who developed AKI following wasp stings. All eligible patients received renal replacement therapy in combination with hemoperfusion. Thereafter, blood purification therapy and HD were performed with a volumetrically controlled machine and 1.7 m2 surface, Fresenius Polysulfone HD filter and SLEDf was undertaken with a volumetrically controlled machine and 1.3 m2 surface, Fresenius Polysulfone HD filter. Results: Forty patients developed stage III AKI following wasp stings, including 14 patients that received SLEDf and 26 patients underwent HD. Thirteen patients were aged less than 60 years and underwent HD (group I), 27 patients were aged at least 60 years, including 13 patients undergoing HD (group II) and 14 patients receiving SLEDf (group III). Groups I and II completed 150 and 162 sessions of HD, respectively, and group III completed 156 sessions of sustained low-efficiency blood purification therapy, including 50 sessions of SLEDf. The time to return to normal serum creatinine levels was 38.8 ± 2.7 days for group I, 47.2 ± 5.3 days for group II, and 39.2 ± 3.3 days for group III. A statistically significant difference was observed in time to normal serum creatinine levels among the three groups. Conclusion: Elderly wasp victims have more severe illness than younger wasp victims and SLEDf is safe and superior to HD in recovery of renal function of elderly wasp victims.
Subject(s)
Acute Kidney Injury/therapy , Insect Bites and Stings/complications , Kidney/physiopathology , Renal Dialysis/methods , Wasps , APACHE , Acute Kidney Injury/etiology , Acute Kidney Injury/physiopathology , Aged , Animals , Creatinine/blood , Female , Humans , Insect Bites and Stings/diagnosis , Insect Bites and Stings/immunology , Kidney/immunology , Male , Middle Aged , Recovery of Function , Retrospective Studies , Treatment Outcome , Wasp Venoms/immunologyABSTRACT
BACKGROUND: To evaluate the treatment of sustained low-efficiency hemodialysis (SLED) against patients with multiple organ dysfunction syndrome (MODS) following wasp stings. METHODS: Clinical data of 35 patients with MODS following wasp stings were retrospectively analysed. These patients were divided into three groups according to the treatment strategy used: 1) hemodialysis (HD) group, 2) continuous veno-venous hemofiltration (CVVH)/HD group, and 3) SLED/HD group. The clinical parameters, treatment outcome, and safety findings were compared among the three groups. RESULTS: The recovery rate (76.92% vs 77.78% vs 91.67%, p = 0.621) and mortality rate (15.38% vs 11.11% vs 8.33%, p = 0.999) were similar among the three groups. When compared to the HD group, patients treated with CVVH/HD or SLED/HD required a shorter period of time to enter into polyuria stage [(24.7 ± 4.3) days vs (20.2 ± 4.7) days vs (18.2 ± 3.0) days, F = 9.11, p = 0.0007], and required a shorter time for serum creatinine to return to normal [(45.7 ± 13.4) days vs (33.1 ± 9.4) days vs (31.9 ± 9.8), F = 5.83, p = 0.0069]; while such parameters had no significant differences between SLED/HD group and CVVH/HD group. The adverse events of hypotension and arrhythmia were found in the HD group, while no adverse events were reported in the SLED/HD and CVVH/HD groups. There was no significant difference in the cost of blood purification treatment between the SLED/HD group and HD group. CONCLUSION: The use of SLED, CVVH and HD provided a comparable recovery and survival rates in patients with MODS secondary to wasp stings. Compared to HD, the use of SLED is recommended as a treatment strategy because of the efficacy on recover of renal function, satisfactory safety outcome, as well as the reasonable treatment cost.
Subject(s)
Continuous Renal Replacement Therapy/standards , Insect Bites and Stings/therapy , Multiple Organ Failure/therapy , Renal Dialysis/standards , Wasps , Adult , Animals , Continuous Renal Replacement Therapy/methods , Female , Humans , Insect Bites and Stings/complications , Insect Bites and Stings/diagnosis , Male , Middle Aged , Multiple Organ Failure/diagnosis , Multiple Organ Failure/etiology , Renal Dialysis/methods , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To explore a clear retinal imaging and output and enhance the development of retinopathy of prematurity (ROP) screening, which is safe and effective for ROP screening in premature infants. METHODS: A computer-assisted binocular indirect ophthalmoscope imaging and output system was equipped with camera and image processing hardware and connected to computers. The process of fundus examination was videotaped (photograph) and output. Simulated eyes were utilized to debug video head and acquire stable and clear fundus images by binocular indirect ophthalmoscope for premature infants. RESULTS: Fundus imaging output technique was sucessfully established. The common reasons of unclear imaging and corresponding solutions were summarized. This technique can capture and output stable and clear fundus images of premature infants. CONCLUSION: Assisted by hardware and software processing, a compute assisted binocular indirect ophthalmoscope imaging and output system was established, which can be used for screening, research, treatment and follow-up of ROP in premature babies to resolve the difficulty in obtaining clear fundus photograph.
