Continuous Blood Purification For Treatment Of Multiorgans Dysfunction Syndrome

Objective: To investigate the effect of continuous blood purification (CBP) on the plasma cytokines in the patients with multiple organ dysfunction syndromes (MODS).Methods: 19 patients were satisfied the criteria of MODS. A double trunk catheter was put into the central vein and the highvolume continuous veno-venous hemofiltration (HV-CVVH) was performed with the Diapact CRRT. The plasma TNF-α, IL-6 and IL-10 were measured by ELISA at 0, 2, 6, 24,36h ,disch following CBP.Results:The levels of BUN, Scr, the plasma TNF-α, ,IL-6 and IL-10 decreased significantly following CBP.In the 19 cases the plasma TNF-α, IL-6, IL-10 cytokines were removed the most obviously between 6 to 24 hours, then increased at 36 hours following CBP,and there was no significant correlation between cytokine removal and the number of organs damaged.The changes of the plasma IL-6, IL-10 decline rate in the three time periods (two hours after CBP treatment and 0 hours, two hours after CBP treatment and six hours, 24 hours after CBP treatment and 6 hours) were different. but there was no difference in the back of time.The decline of IL-6 at two hours after CBP treatment and 0 hours, at two hours after CBP treatment and six hours, was higher than the decline of IL-10.and only the decline of IL-10 was higher IL-6 at 24 hours after CBP treatment and 6 hoursCondusion:①Serum IL-6, IL-10, TNF-αwere significantly increased in the patients with (MODS).But the anti-inflammatory cytokines IL-10 release later than the release of IL-6. Early stage inflammatory response was main, but advanced stage the anti-inflammatory response became dominant. Imbalance between them has led to the development of MODS.②Continuous blood purification can effectively clear the cell factor IL-6, IL-10 and TNF-α, and to 6-24 hours after the removal of CBP was most significant, the best time of second continuous blood purification is After the first CBP 24-36 hours.③Application of CBP could significantly reduce the level of serum anti-inflammatory and pro-inflammatory cytokines, the clearance rate of IL-6 and IL-10 in 2, 6, 24 hours was significant.In 24hours after CBP treatment the anti-inflammatory cytokines IL-10was cleared mainly. There was no significant correlation between cytokine removal and the number of organs damaged.④CBP can reduce organs damage and reduce disability. CBP can improve the lung Oxygenation, improve the biochemical function, and markedly improved the survival rate of patients with MODS. CBP could remove many inflammatory cytokines in plasma,and improve the blood biochemical markers in patients with MODS. PART TWO CONTINUOUS BLOOD PURIFICATION FOR TREATMENT OF 31 MULTIORGANS DYSFUNCTION SYNDROME CASES CAUSED BY BEE STINGObjective: To observe the effect of continuous blood purification for treatment of multiorgans dysfunction syndrome caused by bee sting.Methods: 31 patients with multiple organ dysfunction syndrome caused by bee sting were treated with continuous blood purification, and the effect was observed.Results: The number of continuous blood purification therapy were 1-8 times per people, 27 cases cured or improved ,the patients'renal function, Liver function, myocardial enzymes ,coagulogram, urine routine returned to normal when discharged ,4 cases died.Conclusions: Continuous blood purification and other comprehensive treatment to unite could significantly increase the patients'the oxygenation capacity, correct acidosis, stable blood pressure and improve perfusion of tissues and organs and blood biochemical Indicators.