title: Continuous plasma filtration adsorption in treatment of severe infection-induced multiple organ dysfunction syndrome.
abstract: Multiple organ dysfunction syndrome (MODS), a high-risk disease, has a fatality rate of 70%. To improve treatment of this disease, in recent years many scholars have explored the pathological and physiological changes of MODS. To observe the curative effect of continuous plasma filtration adsorption (CPFA) in the treatment of MODS, we selected 96 patients who were diagnosed with severe infection-induced MODS and were treated in the First Affiliated Hospital of Zhengzhou University between February 2012 and October 2014 and divided them into an observation group and a control group. Besides conventional treatment, the observation group was also given CFPA in combination with high volume hemofiltration (HVHF), while the control group only received HVHF. Changes of blood routine index, balance of electrolyte and acid-base as well as vital signs were observed before and after treatment. Also, blood, kidney and blood gas were examined. For all patients, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were recorded at the start of treatment (0 h), and 5 h and 10 h after treatment. It was found that both therapies could lower blood urea nitrogen (BUN) and creatinine levels and maintain balance of electrolyte and acid-base, but had no obvious influence on leukocyte, blood platelet and hematocrit. In the observation group, PaO(2)/FiO(2) and mean arterial pressure (MAP) were significantly improved after surgery (P less than 0.05), while Acute Physiology and Chronic Health Evaluation (APACHE) II score had an obvious decrease (P less than 0.05). In contrast, the control group was observed with insignificantly changed PaO(2)/FiO(2), MAP and APACHE II score (P>0.05). TNF-α, IL-6 and CRP levels of the two groups had no statistically significant difference at the start of treatment (P>0.05), but TNF-α, IL-6 and CRP levels of the observation group became remarkably lower than those of the control group 5 h and 10 h after treatment (P less than 0.05). Therefore, CPFA is proved to be safe and effective in treating patients with severe infection-induced MODS as it can lower the level of proinflammatory cytokines and improve the level of anti-inflammatory cytokines; thus, it is worthy of clinical promotion.
authors.affiliation: Emergency Department, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: S L
authors.initials: SL
authors.lastname: Yin
authors.affiliation: Emergency Department, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: C
authors.initials: C
authors.lastname: Lan
authors.affiliation: Emergency Department, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Pei
authors.affiliation: Emergency Department, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Zu
mesh_terms: D018806:APACHE; D000293:Adolescent; D000327:Adsorption; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007239:Infections / Q000150:complications*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000276:immunology / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein