The Clinical Trial In Evaluating The Efficacy And Safety Of CRRT In The Treatment Of Burn Sepsis

Objective: To evaluate the potential efficacy and safety of continuous renal replacement therapy in postburn sepsis.Methods: Twenty patients with TBSA>50% and being diagnosed sepsis were enrolled in this study. The patients were divided into CRRT group(N=10)and control group(non CRRT,N=10) . Plasma and ultrafiltrate liquid levels of LPS,TNF-α,IL-1β,IL-6 and IL-8 were monitored dynamically with the observation of clinical signs of postburn sepsis concomitantly.Results: ① The descenting range of plasma levels of endotoxin of burn sepsis patients treated by CRRT were 70% and 98% after the first hour and 60 hours respectively.The plasma endotoxin level of control group ascended to 15%(P<0.01).② The descenting range of plasma level of TNF-α,IL-1β,IL-6 and IL-8 after 60 hours in CRRT group were 77.1%,70%,81.2%,75% respectively.The ascending range of cytokines in control group after 60 hours were 9.4%,14.7%,20.5%, 9% respectively(P<0.01).③ The level of blood pressure rised 1.1 KPa and the dosage of dopamine reduced in CRRT group(P<0.05). ④ The temperature of CRRT group with hyperthermia descented 1.1centigrade averagely after two hours,and that with hypothermia ascended 0.6centigrade averagely after eight hours. ⑤ The myocardiac zymogram and the mental symptom of CRRT group were improved(P<0.05). ⑥ Endotoxin and tumor necrosis factor alpha had not been detected from ultrafiltrate liquid of CRRT group.The amount of IL-1β,IL-6 and IL-8 in ultrafiltrate liquid equaled to 28%,15%,22% of the circulating blood respectively.⑦No emergence of complication related to CRRT occurred,such as bleeding,infection or thrombosis.Conclusion: CRRT could effectively eliminate endotoxin and cytokines in burn sepsis patients, improved organ function. CRRT was safe and feasible.