Clinical Research Of CVVH In Patient With Sepsis Complicated By ALI/ARDS

Objective: to observe the clinical efficacy of hemofiltration treatment in patients with sepsis complicated by lung injury and compare the clinical efficacy, APACHE II scores, and prognosis of hemofiltration treatment at different stage, which lay a foundation for the clinical treatment of sepsis accompany by lung injury.Methods: by application of retrospective contrast research method, 45 sepsis patients with ALI/ARDS admitted to ICU of Xiangya hospital between January 2007 and octoble 2008 were selected into study. The 45 patients were divided into three groups based on the hemofiltration treatment time: the 24h continuous blood purification group(CVVHA, n=15), the 10h continuous blood purification group(CVVHB, n=15) and the control group(n=15). All the patient in CVVH group begin hemofiltration treatment within 24 hours after admission.During the observation period the former 48h ,the patients' heart rate, mean arterial pressure ,respiratory rate, body temperature and APACHE II score were recorded, as well as changes in blood biochemistry parameters, arterial blood-gas analysis before, after and during treatment.Results: during the treatment, patient in CVVH group shows a stable hemodynamics without severe adverse effect occurred. Compared with the contrast group, patient in the two CVVH group present a statistically significant decreased heart rate, respiratory rate, body temperature and improved clinical manifestation. however, the comparison between CVVH(A) and CVVH(B) shows no significant different. in contrast to control group, patients' PaO₂/FiO₂ in the two CVVH group increased gradually, at the point of 24h after the treatment, the results shows a significant different. there is no significant changes of serum sodium, chloride concentration observed, the potassium is marginally decreased but shows no statistically significant compared with contrast group. after treatment, the scores of APACHE II were decreased. As to the mortalities, the CVVH group seems better than the control group,Conclusion: CVVH treatment stabilize the hemodynamics in sepsis ALI/ARDS, most patient were well-tolerated without severe side effect occurred.Early application of CVVH treatment to sepsis patient complicated by ALI/ARDS ameliorate oxygen pressure and PaO2/FiO2Compared to the 10h CVVH group, the 24h consecutive treatment group shows no significant differences.The CVVH treatment have the potential to be an important assist therapeutic means for sepsis patient complicated by ALI/ARDS.