[Effect of high volume hemofiltration on respiration, hemodynamics and oxygen metabolism in sepsis with acute respiratory distress syndrome].
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue
; 18(11): 657-60, 2006 Nov.
Article
in Zh
| MEDLINE
| ID: mdl-17092413
ABSTRACT
OBJECTIVE:
To investigate the effect of continuous high volume hemofiltration (HVHF) on respiration, hemodynamics, and oxygen metabolism in severe sepsis patients with acute respiratory distress syndrome (ARDS).METHODS:
Twelve adult patients with ARDS received mechanical ventilation and HVHF (80 mlxkg(-1)xh(-1)) lasting 12-18 hours every day. The cardiac output (CO), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), mean pulmonary arterial pressure (MPAP), pulmonary artery wedge pressure (PAWP), arterial oxygen content (CaO(2)), O(2) content of mixed venous blood (CvO(2)), oxygen consumption (VO(2)), oxygen delivery (DO(2)) and oxygen extraction rate (O(2)ER) were measured with the aid of a Swan-Ganz catheter, the thoracic fluid content (TFC) were measured with BioZ(r) Cardio Dynamics. Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-8 and IL-10 were measured pre-continuous HVHF and after continuous HVHF by enzyme linked immunoadsorbent assay (ELISA). Acute physiology and chronic health evaluation II (APACHEII) scores, multiple organ dysfunction syndrome (MODS) evaluation scores and PaO(2)/FiO(2) were observed before and after HVHF.RESULTS:
There were significant lowering of concentrations of TNF-alpha, IL-6 and IL-8 after HVHF at 72 hours (all P<0.05), and also in MPAP, PVR and TFC after 48 hours (all P<0.05). DO(2), VO(2) and O(2)ER were stabilized at 72 hours with amelioration of partial pressure of oxygen in artery (PaO(2)), PaO(2)/FiO(2) and peak airway pressure (Ppeak) (P<0.05 or P<0.01).CONCLUSION:
Continuous HVHF shows significant beneficial effects on pulmonary function of severe sepsis patients with ARDS as a result of removal of cytokines, decrease of TFC and amelioration of disturbance in respiration, hemodynamics and oxygen metabolism.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Hemofiltration
/
Sepsis
Type of study:
Etiology_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
Zh
Journal:
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue
Journal subject:
MEDICINA DE EMERGENCIA
/
TERAPIA INTENSIVA
Year:
2006
Document type:
Article
Affiliation country:
China