Objective To explore the efficacy of oXiris hemofilter in the treatment of severe burn patients complicated with sepsis and acute kidney injury. Method The clinical data of 5 patients with severe burn complicated with sepsis and acute kidney injury treated with continuous venovenous hemofiltration (CVVHDF) with oXiris hemofiltration in the hemodialysis center of General Hospital of Ningxia Medical University from May 2018 to February 2021 were retrospectively analyzed. The changes in general vital signs (body temperature, MAP, heart rate, respiration, urine volume, etc.), blood routine, blood gas analysis, and biochemical indexes were observed in 5 patients before and 24 hours after CVVHDF treatment with oXiris hemofiltration, and the Sequential Organ Failure Assessment (SOFA) score was calculated respectively. Results ①In the following 24 hours after CVVHDF with oXiris hemofiltration, compared with before treatment, the urine volume of 24 hours (Z=-2.069, P=0.039), the platelets count (t=-3.977, P =0.001) were increased, and the serum sodium level (t=2.652, P =0.016) and the SOFA score (t=4.265, P＜0.001) was decreased. The indexes of body temperature(t=-0.258, P=0.799), MAP (t=0.168, P=0.868), heart rate(t=1.057, P=0.304), respiration (t=0.481, P=0.636), PH(t=1.304, P=0.208), WBC (t=-1.616, P=0.123), serum bilirubin(t=0.560, P=0.582), serum creatinine (t=0.755, P=0.459) were improved, but there was no significant difference before and after treatment. ②The 28-day survival rate of these patients was 60%. Conclusions CVVHDF therapy with oXiris hemofiltration can improve coagulation function, promote the recovery of kidney function, reduce SOFA score in severe burn patients complicated by sepsis and acute kidney injury.
PENG Jia-Nan
,
ZHANG Ting
,
LUAN Feng-Wu
,
ZHAO Li-Hong
,
CHEN Meng-Hua
. Observation on the efficacy of oXiris hemofilter in the treatment of severe burn complicated with sepsis and acute kidney injury[J]. Chinese Journal of Blood Purification, 2023
, 22(06)
: 406
-409
.
DOI: 10.3969/j.issn.1671-4091.2023.06.002
[1] 柴家科.实用烧伤外科学[M].北京：人民军医出版社，2014, 131-136.
[2]Cruz DN, Antonelli M, Fumagalli R, Foltran F, Brienza N, Donati A, et al.Early use of polymyxinB hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial[J].JAMA, 2009, 301(23):2445-2452
[3]Dellinger RP, Bagshaw SM, Antonelli M, Foster DM, Klein DJ, Marshall JC, et al.EUPHRATES Trial InvestigatorsEffect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial.[J].JAMA The Journal of the American Medical Association, 2018, 320(14):1455-1463
[4]Shum H P, Chan K C, Kwan M C, et al.Application of endotoxin and cytokine adsorption haemofilter in septic acute kidney injury due to Gram-negative bacterial infection[J].Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Academy of Medicine, 2013, 19(6):491-491
[5]Borthwick E M, Hill C J, Rabindranath K S, et al..High-volume haemofiltration for sepsis in adults.[J].Cochrane Database Syst Rev, 2017, 1(1):CD008075-CD008075
[6]Payen D M, Guilhot J, Launey Y, et al.Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial[J].Intensive care medicine, 2015, 41(6):975-984
[7]Monard C, Rimmelé T, Ronco C.Extracorporeal Blood Purification Therapies for Sepsis[J].Blood Purif, 2019, 47(Suppl 3):1-14
[8]Adamik B, Smiechowicz J, Zielinski S, Kübler A.Use of extracorporeal endotoxin elimination therapy for septic shock[J].Crit Care, 2013, 17(Suppl 2):66-66
[9]Turani F, Candidi F, Barchetta R, Grilli E, Belli A, Papi E, et al.Continuous renal replacement therapy with the adsorbent membrane oXiris in septic patients: a clinical experience[J].Crit Care, 2013, 17(Suppl 2):63-63
[10]Malard B, Lambert C, Kellum JA.In vitro comparison of the adsorption of inflammatory mediators by blood purification devices[J].Intensive Care Med Exp, 2018, 6(1):12-12
[11]Lavaud S, Canivet E, Wuillai A, Maheut H, Randoux C, Bonnet JM, et al.Optimal anticoagulation strategy in haemodialysis with heparin-coated polyacrylonitrile membrane[J].Nephrol Dial Transplant, 2003, 18(10):2097-2104
[12]Chanard J, Lavaud S, Maheut H, Kazes I, Vitry F, Rieu P.The clinical evaluation of lowdose heparin in haemodialysis: a prospective study using the heparin-coated AN69 ST membrane[J].Nephrol Dial Transplant, 2008, 23(6):2003-2009
[13]Lumlertgul N, Srisawat N.The haemodynamic effects of oXiris haemofifi lter in septic shock patients requiring renal support: a single centre experience[J].Int J Artif Organs, 2021, 44(1):17-24
