title: The influence of high volume hemofiltration on extra vascular lung water and alveolar-arterial oxygen pressure difference in patients with severe sepsis.
abstract: OBJECTIVE
  To explore the effects of high-volume hemofiltration (HVHF) on the plasma interleukin-6 (IL-6), pro-calcitonin (PCT), extra vascular lung water index (EVLWI) and alveolar-arterial oxygen exchange in patients with septic shock.
  
  
  METHODS
  97 cases intensive patients with septic shock were enrolled  from Department of Intensive Care Unit (ICU) of the Provincial Hospital affiliated to Shandong University between January 2011 and December 2014. According to the puting into practice of high-volume hemofiltration (HVHF) or not, all the patients were divided in two groups (NHVHF group, group A, n = 46 cases) and (HVHF group, group B, n = 51 cases). The plasma IL-6, PCT intrathoracic blood volume index (ITBVI), extra-vascular lung water index (EVLWI) and pulmonary vascular permeability index(PVPI) was detected before treatment and after treatment 24h, 72h The Alveolar- arterial oxygen pressure difference P(A-a)DO2 was checked by arterial blood gas analysis (ABGA) at first and after treatment 24 hour, 72 hour, 7 day in two groups. The mortality at 28 day was compared between two groups.
  
  
  RESULTS
  After 72h treatment, the plasma IL-6, PCT in group B has a significant decrease. After 72h treatment, the level ITBVI, EVLWI and PVPI in group B had a significant improvement. The levels of P(A-a)DO2 in HVHF group were reduced more significantly than N-HVHF group after 7 day. The EVLWI and P(A-a)DO2 had a significant positive correlation (correlation ratio = 0.712, 95% confident interval [0.617, 0.773], p = 0.001). The mortality at 28 day had a significant decrease between groups (15.22% vs. 34.15% χ2 = 4.242, p = 0.038).
  
  
  CONCLUSIONS
  HVHF could decrease plasma inflammatory factors and EVLWI so that it could improve the levels of alveolar-arterial-oxygen exchange in patients with septic shock, so it could improve the survival rate of patients.
authors.affiliation: Department of Endocrinology and Metabolism, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, P. R. China. hongsheng-ren@163.com.
authors.forename: F
authors.initials: F
authors.lastname: Jing
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: Y-F
authors.initials: YF
authors.lastname: Chu
authors.forename: J-J
authors.initials: JJ
authors.lastname: Jiang
authors.forename: M
authors.initials: M
authors.lastname: Ding
authors.forename: Y-P
authors.initials: YP
authors.lastname: Wang
authors.forename: C-T
authors.initials: CT
authors.lastname: Wang
authors.forename: H-S
authors.initials: HS
authors.lastname: Ren
mesh_terms: D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis / Q000379:methods / Q000639:trends; D001810:Blood Volume / Q000502:physiology; D015633:Extravascular Lung Water / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006440:Hemofiltration / Q000379:methods / Q000639:trends*; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000639:trends; D010100:Oxygen / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000628:therapy
chemical_list: D010100:Oxygen