不同时机连续性肾脏替代治疗对急性呼吸窘迫综合征的影响

doi:10.3969/j.issn.1002-1949.2018.01.015

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (1): 67-71 DOI: 10.3969/j.issn.1002-1949.2018.01.015

Initiation time of continuous renal replacement therapy on patients with acute respiratory distress syndrome

Meng Li-jun, Liu Wei-li

Department of Intensive Care Medicine, Hospital Affiliated of Yangzhou University, Yangzhou 225001, China

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Abstract Objective: To investigate the optimal time of initiation of continuous renal replacement therapy (CRRT) in patients with acute respiratory distress syndrome(ARDS). Methods: Forty-eight patients with ARDS were randomly divided into two groups: early CRRT group (within 24 hours after ARDS onset) and late CRRT group (24 hours after ARDS onset). Ventilation parameter, including PaO2/FiO2, positive end expiratory pressure（PEEP）, plateau pressure（Pplat） and hemodynamic parameters including central venous pressure(CVP), mean arterial pressure(MAP), blood lactic acid(Lac) between the early and the late CRRT groups were observed at the time points of 0 h, 2 days later and 7 days later. Fluid balance, the duration of total mechanical ventilation, intensive care unit (ICU) stay, and the 28-day mortality rate were assessed. Results: There were statistical increases in PaO2/FiO2, MAP and statistical decreases in PEEP, Pplat, Lac, and CVP from 2 days after the treatment in the patients of the early CRRT group. Furthermore, there were significantly differences in those indicators between two groups at 2 days and 7 days. The duration of total mechanical ventilation and ICU stay of the early CRRT group were (8.5±3.1) days and (12±2) days respectively, both significantly shorter than that of the late CRRT group ［(14.4±4.1) days and (19±5) days, P<0.05］. The 28-day mortality rate between the two groups were 20.83% vs 37.5%(P<0.05). Conclusion: CRRT within 24 hours can improve oxygenation, shorten the duration of mechanical ventilation and ICU stay, decrease mortality in ARDS patients, and is associated with favorable clinical outcomes in ARDS patients.

Received: 31 July 2017

About author:: Meng Li-jun, E-mail: menglj_2006@sina.com

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Meng Li-jun,Liu Wei-li. Initiation time of continuous renal replacement therapy on patients with acute respiratory distress syndrome[J]. Chinese Journal of Critical Care Medicine, 2018, 38(1): 67-71.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.01.015 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I1/67

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