title: Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome.
abstract: Objective. To investigate the effects of 72-hour early-initiated continuous venovenous hemofiltration (ECVVH) treatment in patients with septic-shock-induced acute respiratory distress syndrome (ARDS) (not acute kidney injury, AKI) with regard to serum E-selectin and measurements of lung function and hemodynamic stability.Methods. This prospective nonblinded single institutional randomized study involved 51 patients who were randomly assigned to receive or not receive ECVVH, an ECVVH group (n= 24) and a non-ECVVH group (n= 27). Besides standard therapies, patients in ECVVH group underwent CVVH for 72 h.Results. At 0 and 24 h after initiation of treatment, arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio, extravascular lung water index (EVLWI), and E-selectin level were not significantly different between groups (allP> 0.05). Compared to non-ECVVH group, PaO2/FiO2is significantly higher and EVLWI and E-selectin level are significantly lower in ECVVH group (allP< 0.05) at 48 h and 72 h after initiation of treatment. The lengths of mechanical ventilation and stay in intensive care unit (ICU) were shorter in ECVVH group (allP< 0.05), but there was no difference in 28-day mortality between two groups.Conclusions. In patients with septic-shock-induced ARDS (not AKI), treatment with ECVVH in addition to standard therapies improves endothelial function, lung function, and hemodynamic stability and reduces the lengths of mechanical ventilation and stay in ICU.
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Jian-Biao
authors.identifier: 0000-0003-0337-2865
authors.initials: JB
authors.lastname: Meng
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Zhi-Zhen
authors.identifier: 0000-0002-2256-9842
authors.initials: ZZ
authors.lastname: Lai
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Xiu-Juan
authors.identifier: 0000-0002-1958-5489
authors.initials: XJ
authors.lastname: Xu
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Chun-Lian
authors.identifier: 0000-0002-6333-9955
authors.initials: CL
authors.lastname: Ji
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Ma-Hong
authors.identifier: 0000-0001-7136-4918
authors.initials: MH
authors.lastname: Hu
authors.affiliation: Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, 234 Gucui Road, Hangzhou 310012, China.
authors.forename: Geng
authors.identifier: 0000-0001-8737-781X
authors.initials: G
authors.lastname: Zhang
mesh_terms: D062186:Arterial Pressure / Q000502:physiology; D019040:E-Selectin / Q000097:blood*; D004727:Endothelium / Q000378:metabolism / Q000503:physiopathology; D015633:Extravascular Lung Water / Q000378:metabolism / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010865:Pilot Projects; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D012772:Shock, Septic / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D019040:E-Selectin; D010100:Oxygen