Objective:To observe and explore the effectiveness and safety of continuous blood purification intervention in the clinical treatment of patients with severe sepsis in the Intensive Care Unit(ICU).Methods:Medical reco...Objective:To observe and explore the effectiveness and safety of continuous blood purification intervention in the clinical treatment of patients with severe sepsis in the Intensive Care Unit(ICU).Methods:Medical records were collected from March 2024 to March 2025,including a total of 54 patients with severe sepsis in the ICU.The patients were divided into two groups using a random number table method:the conventional group(27 patients receiving conventional treatment)and the observation group(27 patients receiving continuous blood purification in addition to conventional treatment).C-reactive protein,arterial lactate,mean arterial pressure,respiration,and heart rate were measured.The Sequential Organ Failure Assessment(SOFA)score was compared,and adverse reactions were observed.Results:The observation group had lower levels of C-reactive protein,arterial lactate,respiration,heart rate,and total SOFA score compared to the conventional group,while the mean arterial pressure was higher(P<0.05).The incidence of adverse reactions during treatment was lower in the observation group than in the conventional group(P<0.05).Conclusion:The use of continuous blood purification in the clinical treatment of patients with severe sepsis in the ICU is effective.It can alleviate the disease,improve vital signs,reduce inflammatory damage,and reduce adverse reactions.展开更多
The incidence of hyperbilirubinemia is high clinically, which is difficult to cure by medication, surgery or interventional therapies. Non-bioartificial liver is the main alternative in the blood purification for hype...The incidence of hyperbilirubinemia is high clinically, which is difficult to cure by medication, surgery or interventional therapies. Non-bioartificial liver is the main alternative in the blood purification for hyperbilirubinemia, which includes plasma exchange, hemoperfusion, hemodialysis, molecular adsorbent recycling system and so on. The research results and clinical experiences in China show that these methods are effective in lowering high levels of bilirubin with fewer side effects. The hyperbilirubinemias of different causes, with different complications or accompanying different diseases can be treated by different methods. Bioartificial liver, hybrid artificial liver support system and adsorbent membrane material have also been studied and their development in reducing hyperbilirubinemias has been achieved. This article gives a brief overview on the actuality and research improvement in blood purification for hyperbilirubinemia in China.展开更多
Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and A...Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and ACLF,standard medical therapy remains the primary therapeutic approach.Liver transplantation(LT)is considered the last option,and in several cases,it is the only intervention that can be lifesaving.Unfortunately,this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a transplant.Another option is to restore impaired liver function with artificial extracorporeal blood purification systems.The first such systems were developed at the end of the 20th century,providing solutions as bridging therapy,either for liver recovery or LT.They enhance the elimination of metabolites and substances that accumulate due to compromised liver function.In addition,they aid in clearance of molecules released during acute liver decompensation,which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy,multiple-organ failure,and other complications of liver failure.As compared to renal replacement therapies,we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these systems.Extracting middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely challenging.The majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and toxins.Furthermore,conventional methods such as plasma exchange are being re-evaluated,and novel adsorption filters are increasingly being used for liver indications.These strategies are very promising for the treatment of liver failure.Nevertheless,the best method,system,or device has not been developed yet,and its probability of getting developed in the near future is also low.Furthermore,little is known about the effects of liver support systems on the overall and transplant-free survival of these patients,and further investigation using randomized controlled trials and meta-analyses is needed.This review presents the most popular extracorporeal blood purification techniques for liver replacement therapy.It focuses on general principles of their function,and on evidence regarding their effectiveness in detoxification and in supporting patients with ALF and ACLF.In addition,we have outlined the basic advantages and disadvantages of each system.展开更多
BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory ...BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory mediators has become a hot topic in critical care medicine.Researchers hypothesize that continuous blood purification(CBP) can effectively eliminate a variety of inflammatory mediators which participate in the occurrence of MODS and adjust the immune imbalance.This study aimed to observe the effects of CBP in MODS patients.METHODS:In this retrospective clinical study,a total of 38 MODS patients,18 males and 20 females,were enrolled.After conventional therapy,all the patients received CBP.Biochemistry,blood gas analysis,oxygenation index,mean arterial blood pressure(MAP),acute physiology and chronic health evaluation(APACHE) II scores were monitored.RESULTS:After CBP,the vital signs of patients were rapidly stable,and electrolyte disorders and acid-base imbalance were corrected.Renal function,blood gas,oxygenation index were all improved.MAP was increased,and APACHE II score was significantly decreased.All patients had good tolerance,stable hemodynamics,and no obvious adverse reaction on CBP compared with pre-CBP.CONCLUSION:CBP can effectively clean toxins,correct electrolyte acid-base balance,and improve systemic inflammatory response syndrome and the organ function of MODS patients.展开更多
There are many patients in the blood purification center who need maintenance hemodialysis to maintain life. Those patients generally havelow resistance and are easily exposed to coronavirus because they go back and f...There are many patients in the blood purification center who need maintenance hemodialysis to maintain life. Those patients generally havelow resistance and are easily exposed to coronavirus because they go back and forth the hospital and residence three times a week andclosely contact with family, caregivers, community personnel, people in various means of transportation, medical staff, and other patientsvisiting hospital. Therefore, the blood purification center has become a high‑risk environment for the spread of COVID-19 infection. In viewof this, our center quickly responded to the formulation and implementation of infection prevention and control measures suitable for thecharacteristics of the blood purification center and continuous renal replacement therapy (CRRT) emergency plan for fever and suspectedpatients. According to these measures, we have a positive effect on preventing and controlling nosocomial infection in the blood purificationcenter.展开更多
Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's...Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's lung,abdominal cavity and blood system are infected,it will cause systemic inflammation and immune dysfunction.Early clinical symptoms are mainly irregular and intermittent fever.When the disease develops to severe sepsis,the children will suffer from acute heart failure,oliguria,respiratory alkalosis and even multiple organ failure.The incidence of death is high.It is reported that the incidence rate of sepsis in children can reach 0.3%,and the mortality rate is 50%.High incidence rate,high mortality rate and high treatment cost are the biggest problems in the pediatric field.In the past,the clinical hope of clearing away heat and toxin,promoting blood circulation and removing stasis,strengthening inflammation and other methods in traditional Chinese medicine,but the treatment effect is not ideal.With the improvement of modem medical understanding of sepsis,continuous blood purification therapy is introduced into the treatment of children with severe sepsis.In order to further explore the effect of continuous blood purification in the treatment of children with severe sepsis,the author summarizes the clinical practice experience and relevant literature,hoping to provide reference for relevant medical staff。展开更多
Plasma was purified in an immobilized L-asparaginase column. The predicted results are in good agreement with experimental data. It is indicated that the mathematical model is suitable for the mass transfer and react...Plasma was purified in an immobilized L-asparaginase column. The predicted results are in good agreement with experimental data. It is indicated that the mathematical model is suitable for the mass transfer and reaction of blood purification.展开更多
Objective: to analyze the effect of early blood purification in the treatment of acute severe poisoning patients. Methods: sixty patients with acute severe poisoning were selected, all of whom met the inclusion and ex...Objective: to analyze the effect of early blood purification in the treatment of acute severe poisoning patients. Methods: sixty patients with acute severe poisoning were selected, all of whom met the inclusion and exclusion conditions of the study. They were grouped according to the treatment sequence. The first 30 patients received conventional detoxification as the reference group, while the second 30 patients received conventional detoxification + early blood purification as the purification group, and the effects were compared. Results: the total effective rate was calculated according to the improvement degree of poisoning symptoms and the recovery of physical indicators. 96.67% (29/30) of patients in the purification group achieved good curative effect, while only 73.33% (22/30) of the reference group, indicating that the efficacy of the purification group was better (P < 0.05). The efficiency of the two methods was analyzed from the perspective of treatment progress. Compared with the reference group, the duration of coma, hospitalization and mechanical ventilation were shorter in the purification group (P < 0.05), indicating that the treatment progress was faster in the purification group. Conclusion: early blood purification while routine detoxification for patients with acute severe poisoning can not only improve the treatment effect, but also speed up the treatment process, which is worthy of promotion.展开更多
In the daily nursing work, we can easily find that the one-sided physical nursing for patients with diabetic nephropathy and blood purification is almost unsatisfactory, and the medical mechanism has gradually changed...In the daily nursing work, we can easily find that the one-sided physical nursing for patients with diabetic nephropathy and blood purification is almost unsatisfactory, and the medical mechanism has gradually changed. Humanistic nursing is an important part of modern nursing. We know what the needs of patients are and what negative factors they have.Humanistic nursing can effectively help improve the quality of medical care.In the process of blood purification treatment for patients with nephropathy, the use of process management can effectively improve the quality of nursing. This scheme is worthy of clinical application and popularization.展开更多
Objective: to explore the clinical effect of continuous blood purification in the treatment of severe renal failure. Methods: a total of 116 patients with severe heart failure and renal failure admitted to Wuxi County...Objective: to explore the clinical effect of continuous blood purification in the treatment of severe renal failure. Methods: a total of 116 patients with severe heart failure and renal failure admitted to Wuxi County People's Hospital of Chongqing from January 2019 to March 2021 were randomly divided into control group and experimental group by digital table classification. The control group and the experimental group received routine blood purification treatment and continuous blood purification treatment, respectively. The changes of cardiac function and renal function were compared between the two groups after treatment. Results: compared with the control group, LVEF, SV, CO in the experimental group were significantly increased, serum creatinine and urea nitrogen concentrations were significantly decreased, and the difference was statistically significant. Conclusion: continuous blood purification in patients with severe heart failure combined with renal failure has a better effect on the improvement of renal and cardiac function, which has certain clinical promotion and application value.展开更多
Objective: the effect of continuous therapy promotes the therapeutic effect of blood purification in the treatment of severe sepsis. Methods: In order to effectively treat the clinical treatment effect of severe sepsi...Objective: the effect of continuous therapy promotes the therapeutic effect of blood purification in the treatment of severe sepsis. Methods: In order to effectively treat the clinical treatment effect of severe sepsis, 300 patients with severe sepsis who came to our hospital for treatment from January 2019 to December 2020 were selected as research objects. They were divided into control group and observation group. Among them, the control group was given the intervention treatment by the conventional treatment. Based on the implementation of the control group, the observation group effectively enhanced the continuity and blood purification intervention therapy. Comparing the satisfaction degree and treatment effect of the overall clinical effect of the two groups of patients in the clinical treatment of severe sepsis, fully observing the reference basis of the treatment effect of interleukin -6, tumor necrosis factor αand the like before and after the treatment of the patients, and simultaneously finding that the patients in the observation group are obviously better than the patients in the control group in the overall related treatment, the detection result data of inflammation, the detection data of disease-related inflammatory factors are improved, and the degree of improvement is high for the patients in the control group, and the two groups of patients have clinical statistical significance in the treatment scheme and satisfaction degree, P < 0.05. Conclusion: combined with the analysis of clinical treatment process of patients with severe sepsis, routine intervention measures and continuous blood purification treatment measures, the overall treatment effect of the two groups of patients is effectively improved, the detection data of relevant inflammatory factors and clinical satisfaction of the two groups of patients are further improved, and the overall treatment effect is effectively enhanced, which is worthy of clinical reference and promotion.展开更多
Objective: to analyze the influencing factors of nursing safety in blood purification, and to deal with them effectively. Methods: the patients who underwent blood purification treatment in our hospital from August 20...Objective: to analyze the influencing factors of nursing safety in blood purification, and to deal with them effectively. Methods: the patients who underwent blood purification treatment in our hospital from August 2018 to August 2019 were selected as the research objects. Patients were divided into observation group and control group. Among them, the observation group had safety problems during blood purification nursing;Patients in the control group did not have any safety problems during blood purification. Two groups of patients were treated with corresponding blood purification nursing methods, and the clinical details of patients were analyzed and summarized. The safety factors in the process of blood purification nursing were investigated in detail and the corresponding countermeasures were formulated. Results: ① After analyzing the single factor of blood purification nursing safety risk, we know that the main safety risks come from nurses, patients themselves, environmental factors, nursing quality management, nursing mode and so on. The difference was statistically significant (P < 0.05). ② After multi-factor analysis, it can be seen that the main safety risks come from nurses, patients themselves, environmental factors, nursing factors and nursing modes. These safety risks are also the only safety risks in blood purification nursing, and the difference is statistically significant (P < 0.05). ③ There was no significant difference after scoring the psychological function, physiological function, physical pain, general health, social function, emotional reaction and mental reaction between the two groups (P > 0.05). After nursing, physiological function, physical pain and general health of the observation group were lower than those of the control group, and the difference was statistically significant (P < 0.05). ④ The comfort of nursing observation group was higher than that of control group, and the difference was statistically significant (P < 0.05). Conclusion: in the process of blood purification nursing for patients, there are many factors that will lead to nursing safety. In the process of treatment, we should first understand the actual problems and formulate targeted treatment methods, so as to improve the nursing safety of patients with blood purification nursing and improve the treatment effect. Therefore, it should be widely popularized in clinical nursing of blood purification.展开更多
Objective: to explore the clinical effect of quality control circle in blood purification nursing management. Methods: 80 hemodialysis patients admitted to our hospital between March 2021 and March 2022 were selected ...Objective: to explore the clinical effect of quality control circle in blood purification nursing management. Methods: 80 hemodialysis patients admitted to our hospital between March 2021 and March 2022 were selected and divided into two groups according to the difference of clinical nursing mode, namely, the experimental group (quality control circle management, n 40 cases) and the control group (traditional management, n 40 cases);The changes of clinical compliance, quality of life, satisfaction and other indicators in the two groups were statistically compared. Results: the compliance, quality of life and satisfaction of the experimental group were better than that of the control group. The data of the two groups were significantly different with statistical advantage (P < 0.05);The complication rate of the experimental group was 7.50%, which was significantly lower than that of the control group (32.50%). The difference was statistically significant (P < 0.05). Conclusion: for the clinical nursing mode of hemodialysis patients, the selection of quality control circle management activities is conducive to reducing the complication rate, improving the quality of life of patients, and greatly improving the satisfaction of patients. Therefore, this nursing management scheme has strong clinical application value.展开更多
Objective:This paper aims to investigate the value of individualized care for critically ill patients receiving continuous blood purification therapy.Methods:89 cases of critically ill patients who were treated from J...Objective:This paper aims to investigate the value of individualized care for critically ill patients receiving continuous blood purification therapy.Methods:89 cases of critically ill patients who were treated from June 2021 to June 2023 were randomly divided into groups,with individualized care in group A and routine care in group B.The differences in clinical indicators,purification effect,quality of life,and complications of blood purification were compared between the groups.Results:Heart rate,respiration,body temperature,and other indicators in group A were better than those in group B,P<0.05.C-reactive protein(CRP),β2-microglobulin(β2-MG),blood urea nitrogen(BUN),and phosphorus(P)in group A were lower than those in group B,P<0.05.Group A had higher quality of life than Group B,P<0.05.The complication rate of blood purification in Group A was lower than that in Group B,P<0.05.Conclusion:During continuous blood purification in critically ill patients,individualized nursing intervention can enhance the effect of blood purification,improve the physiological indicators of patients,and reduce the complications of blood purification,which is highly effective and feasible.展开更多
Objective: to study the effect of high-quality nursing in blood purification nursing. Methods: a total of 70 patients undergoing blood purification in our hospital from January 2021 to December 2021 were selected and ...Objective: to study the effect of high-quality nursing in blood purification nursing. Methods: a total of 70 patients undergoing blood purification in our hospital from January 2021 to December 2021 were selected and randomly divided into two groups, 35 patients in the observation group (high-quality care) and 35 patients in the control group (routine care). The nursing effects after different nursing methods were compared. Results: compared with the control group receiving routine care, the observation group had a relatively low incidence of complications, good blood biochemical indicators, fewer adverse events and high quality of care (P<0.05). Conclusion: high-quality nursing is very necessary and effective for blood purification center.展开更多
Objective: to study the technology of blood purification nursing service quality control and its application effect. Methods: from November 2019 to November 2020, 62 clinical patients who underwent blood purification ...Objective: to study the technology of blood purification nursing service quality control and its application effect. Methods: from November 2019 to November 2020, 62 clinical patients who underwent blood purification treatment in the hospital were selected as the main research objects, and randomly divided into two groups by computer, with 31 cases in each group. Routine management mode was given to the reference group and quality control was given to the experimental group. The occurrence state of adverse reactions and the scoring of nursing service quality were compared between the two groups. Results: the incidence of adverse reactions was compared between the two groups. The experimental group was significantly better than the reference group (P < 0.05). Compared with nursing service quality score, the experimental group was significantly better than the control group (P < 0.05). Conclusion: quality control of blood purification nursing can greatly improve the quality of service, reduce the incidence of adverse reactions, and reduce the impact of disease and treatment on patients, which is worthy of promotion and application.展开更多
The artificial liver blood purification system(ALBPS),referred to as the artificial liver system,has been extensively used for treatment of patients with liver failure or other organ failures,and its efficacy has been...The artificial liver blood purification system(ALBPS),referred to as the artificial liver system,has been extensively used for treatment of patients with liver failure or other organ failures,and its efficacy has been well-documented.To further standardize the clinical application of ALBPS,the Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association and other institutions invited experts to update the 2016 version of ALBPS guidelines and develop the Guidelines on Application of Artificial Liver Blood Purification System(version 2023).In line with the latest international research advancements,this updated version compre-hensively elaborates on various aspects of ALBPS,including treatment mode selection,anticoagulation program implementation,nursing and operational procedures,indications and relative contraindications,common complications and their management,as well as management regulations of the system.These guidelines will provide guidance for the effective application of ALBPS for treatment of critically ill patients.展开更多
Objectives To evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding ...Objectives To evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding tendencies. Methods Forty critically ill patients being treated by continuous blood purification (CBP) were involved in this study. Due to their bleeding tendencies, regional citrate anticoagulation treatment was given to all of them. Those with hepatic function impairment (n=10) were classified as Group A, those with hypoxemia were classified as Group B (n=10), and the others as Group C (n=20). Blood samples were collected before treatment, and at 4, 12, 24, 36, and 48 hour intervals during CBP. These samples then were used arterial blood gas analysis, whole blood activated clotting time (WBACT) pre- and post-filter, and serum ionized calcium examination. Results WBACT pre-filter showed little fluctuant through the 48hr period of CBP, and WBACT post-filter showed obvious prolongation than that of the pre-filter (P<0.05) at all time points. Metabolic acidosis was found in Group A patients before CBP, and improved during CBP. Normal acid-base conditions of patients were disturbed and deteriorated in Group B during CBP, but not in Group C. Serum ionized calcium was maintained at a normal range during CBP in Group A and C patients, but declined significantly in Group B patients (vs. pre-treatment, P<0.05). Conclusions Regional citrate anticoagulation can be safely used in conjunction with CBP treatment for patients with hepatic function impairment , but may induce acidosis and a decline in serum ionized calcium when used with hypoxemic patients.展开更多
文摘Objective:To observe and explore the effectiveness and safety of continuous blood purification intervention in the clinical treatment of patients with severe sepsis in the Intensive Care Unit(ICU).Methods:Medical records were collected from March 2024 to March 2025,including a total of 54 patients with severe sepsis in the ICU.The patients were divided into two groups using a random number table method:the conventional group(27 patients receiving conventional treatment)and the observation group(27 patients receiving continuous blood purification in addition to conventional treatment).C-reactive protein,arterial lactate,mean arterial pressure,respiration,and heart rate were measured.The Sequential Organ Failure Assessment(SOFA)score was compared,and adverse reactions were observed.Results:The observation group had lower levels of C-reactive protein,arterial lactate,respiration,heart rate,and total SOFA score compared to the conventional group,while the mean arterial pressure was higher(P<0.05).The incidence of adverse reactions during treatment was lower in the observation group than in the conventional group(P<0.05).Conclusion:The use of continuous blood purification in the clinical treatment of patients with severe sepsis in the ICU is effective.It can alleviate the disease,improve vital signs,reduce inflammatory damage,and reduce adverse reactions.
文摘The incidence of hyperbilirubinemia is high clinically, which is difficult to cure by medication, surgery or interventional therapies. Non-bioartificial liver is the main alternative in the blood purification for hyperbilirubinemia, which includes plasma exchange, hemoperfusion, hemodialysis, molecular adsorbent recycling system and so on. The research results and clinical experiences in China show that these methods are effective in lowering high levels of bilirubin with fewer side effects. The hyperbilirubinemias of different causes, with different complications or accompanying different diseases can be treated by different methods. Bioartificial liver, hybrid artificial liver support system and adsorbent membrane material have also been studied and their development in reducing hyperbilirubinemias has been achieved. This article gives a brief overview on the actuality and research improvement in blood purification for hyperbilirubinemia in China.
文摘Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and ACLF,standard medical therapy remains the primary therapeutic approach.Liver transplantation(LT)is considered the last option,and in several cases,it is the only intervention that can be lifesaving.Unfortunately,this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a transplant.Another option is to restore impaired liver function with artificial extracorporeal blood purification systems.The first such systems were developed at the end of the 20th century,providing solutions as bridging therapy,either for liver recovery or LT.They enhance the elimination of metabolites and substances that accumulate due to compromised liver function.In addition,they aid in clearance of molecules released during acute liver decompensation,which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy,multiple-organ failure,and other complications of liver failure.As compared to renal replacement therapies,we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these systems.Extracting middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely challenging.The majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and toxins.Furthermore,conventional methods such as plasma exchange are being re-evaluated,and novel adsorption filters are increasingly being used for liver indications.These strategies are very promising for the treatment of liver failure.Nevertheless,the best method,system,or device has not been developed yet,and its probability of getting developed in the near future is also low.Furthermore,little is known about the effects of liver support systems on the overall and transplant-free survival of these patients,and further investigation using randomized controlled trials and meta-analyses is needed.This review presents the most popular extracorporeal blood purification techniques for liver replacement therapy.It focuses on general principles of their function,and on evidence regarding their effectiveness in detoxification and in supporting patients with ALF and ACLF.In addition,we have outlined the basic advantages and disadvantages of each system.
文摘BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory mediators has become a hot topic in critical care medicine.Researchers hypothesize that continuous blood purification(CBP) can effectively eliminate a variety of inflammatory mediators which participate in the occurrence of MODS and adjust the immune imbalance.This study aimed to observe the effects of CBP in MODS patients.METHODS:In this retrospective clinical study,a total of 38 MODS patients,18 males and 20 females,were enrolled.After conventional therapy,all the patients received CBP.Biochemistry,blood gas analysis,oxygenation index,mean arterial blood pressure(MAP),acute physiology and chronic health evaluation(APACHE) II scores were monitored.RESULTS:After CBP,the vital signs of patients were rapidly stable,and electrolyte disorders and acid-base imbalance were corrected.Renal function,blood gas,oxygenation index were all improved.MAP was increased,and APACHE II score was significantly decreased.All patients had good tolerance,stable hemodynamics,and no obvious adverse reaction on CBP compared with pre-CBP.CONCLUSION:CBP can effectively clean toxins,correct electrolyte acid-base balance,and improve systemic inflammatory response syndrome and the organ function of MODS patients.
文摘There are many patients in the blood purification center who need maintenance hemodialysis to maintain life. Those patients generally havelow resistance and are easily exposed to coronavirus because they go back and forth the hospital and residence three times a week andclosely contact with family, caregivers, community personnel, people in various means of transportation, medical staff, and other patientsvisiting hospital. Therefore, the blood purification center has become a high‑risk environment for the spread of COVID-19 infection. In viewof this, our center quickly responded to the formulation and implementation of infection prevention and control measures suitable for thecharacteristics of the blood purification center and continuous renal replacement therapy (CRRT) emergency plan for fever and suspectedpatients. According to these measures, we have a positive effect on preventing and controlling nosocomial infection in the blood purificationcenter.
文摘Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's lung,abdominal cavity and blood system are infected,it will cause systemic inflammation and immune dysfunction.Early clinical symptoms are mainly irregular and intermittent fever.When the disease develops to severe sepsis,the children will suffer from acute heart failure,oliguria,respiratory alkalosis and even multiple organ failure.The incidence of death is high.It is reported that the incidence rate of sepsis in children can reach 0.3%,and the mortality rate is 50%.High incidence rate,high mortality rate and high treatment cost are the biggest problems in the pediatric field.In the past,the clinical hope of clearing away heat and toxin,promoting blood circulation and removing stasis,strengthening inflammation and other methods in traditional Chinese medicine,but the treatment effect is not ideal.With the improvement of modem medical understanding of sepsis,continuous blood purification therapy is introduced into the treatment of children with severe sepsis.In order to further explore the effect of continuous blood purification in the treatment of children with severe sepsis,the author summarizes the clinical practice experience and relevant literature,hoping to provide reference for relevant medical staff。
基金the National Natural Science Foundation of China (No. 29806006).
文摘Plasma was purified in an immobilized L-asparaginase column. The predicted results are in good agreement with experimental data. It is indicated that the mathematical model is suitable for the mass transfer and reaction of blood purification.
文摘Objective: to analyze the effect of early blood purification in the treatment of acute severe poisoning patients. Methods: sixty patients with acute severe poisoning were selected, all of whom met the inclusion and exclusion conditions of the study. They were grouped according to the treatment sequence. The first 30 patients received conventional detoxification as the reference group, while the second 30 patients received conventional detoxification + early blood purification as the purification group, and the effects were compared. Results: the total effective rate was calculated according to the improvement degree of poisoning symptoms and the recovery of physical indicators. 96.67% (29/30) of patients in the purification group achieved good curative effect, while only 73.33% (22/30) of the reference group, indicating that the efficacy of the purification group was better (P < 0.05). The efficiency of the two methods was analyzed from the perspective of treatment progress. Compared with the reference group, the duration of coma, hospitalization and mechanical ventilation were shorter in the purification group (P < 0.05), indicating that the treatment progress was faster in the purification group. Conclusion: early blood purification while routine detoxification for patients with acute severe poisoning can not only improve the treatment effect, but also speed up the treatment process, which is worthy of promotion.
文摘In the daily nursing work, we can easily find that the one-sided physical nursing for patients with diabetic nephropathy and blood purification is almost unsatisfactory, and the medical mechanism has gradually changed. Humanistic nursing is an important part of modern nursing. We know what the needs of patients are and what negative factors they have.Humanistic nursing can effectively help improve the quality of medical care.In the process of blood purification treatment for patients with nephropathy, the use of process management can effectively improve the quality of nursing. This scheme is worthy of clinical application and popularization.
文摘Objective: to explore the clinical effect of continuous blood purification in the treatment of severe renal failure. Methods: a total of 116 patients with severe heart failure and renal failure admitted to Wuxi County People's Hospital of Chongqing from January 2019 to March 2021 were randomly divided into control group and experimental group by digital table classification. The control group and the experimental group received routine blood purification treatment and continuous blood purification treatment, respectively. The changes of cardiac function and renal function were compared between the two groups after treatment. Results: compared with the control group, LVEF, SV, CO in the experimental group were significantly increased, serum creatinine and urea nitrogen concentrations were significantly decreased, and the difference was statistically significant. Conclusion: continuous blood purification in patients with severe heart failure combined with renal failure has a better effect on the improvement of renal and cardiac function, which has certain clinical promotion and application value.
文摘Objective: the effect of continuous therapy promotes the therapeutic effect of blood purification in the treatment of severe sepsis. Methods: In order to effectively treat the clinical treatment effect of severe sepsis, 300 patients with severe sepsis who came to our hospital for treatment from January 2019 to December 2020 were selected as research objects. They were divided into control group and observation group. Among them, the control group was given the intervention treatment by the conventional treatment. Based on the implementation of the control group, the observation group effectively enhanced the continuity and blood purification intervention therapy. Comparing the satisfaction degree and treatment effect of the overall clinical effect of the two groups of patients in the clinical treatment of severe sepsis, fully observing the reference basis of the treatment effect of interleukin -6, tumor necrosis factor αand the like before and after the treatment of the patients, and simultaneously finding that the patients in the observation group are obviously better than the patients in the control group in the overall related treatment, the detection result data of inflammation, the detection data of disease-related inflammatory factors are improved, and the degree of improvement is high for the patients in the control group, and the two groups of patients have clinical statistical significance in the treatment scheme and satisfaction degree, P < 0.05. Conclusion: combined with the analysis of clinical treatment process of patients with severe sepsis, routine intervention measures and continuous blood purification treatment measures, the overall treatment effect of the two groups of patients is effectively improved, the detection data of relevant inflammatory factors and clinical satisfaction of the two groups of patients are further improved, and the overall treatment effect is effectively enhanced, which is worthy of clinical reference and promotion.
文摘Objective: to analyze the influencing factors of nursing safety in blood purification, and to deal with them effectively. Methods: the patients who underwent blood purification treatment in our hospital from August 2018 to August 2019 were selected as the research objects. Patients were divided into observation group and control group. Among them, the observation group had safety problems during blood purification nursing;Patients in the control group did not have any safety problems during blood purification. Two groups of patients were treated with corresponding blood purification nursing methods, and the clinical details of patients were analyzed and summarized. The safety factors in the process of blood purification nursing were investigated in detail and the corresponding countermeasures were formulated. Results: ① After analyzing the single factor of blood purification nursing safety risk, we know that the main safety risks come from nurses, patients themselves, environmental factors, nursing quality management, nursing mode and so on. The difference was statistically significant (P < 0.05). ② After multi-factor analysis, it can be seen that the main safety risks come from nurses, patients themselves, environmental factors, nursing factors and nursing modes. These safety risks are also the only safety risks in blood purification nursing, and the difference is statistically significant (P < 0.05). ③ There was no significant difference after scoring the psychological function, physiological function, physical pain, general health, social function, emotional reaction and mental reaction between the two groups (P > 0.05). After nursing, physiological function, physical pain and general health of the observation group were lower than those of the control group, and the difference was statistically significant (P < 0.05). ④ The comfort of nursing observation group was higher than that of control group, and the difference was statistically significant (P < 0.05). Conclusion: in the process of blood purification nursing for patients, there are many factors that will lead to nursing safety. In the process of treatment, we should first understand the actual problems and formulate targeted treatment methods, so as to improve the nursing safety of patients with blood purification nursing and improve the treatment effect. Therefore, it should be widely popularized in clinical nursing of blood purification.
文摘Objective: to explore the clinical effect of quality control circle in blood purification nursing management. Methods: 80 hemodialysis patients admitted to our hospital between March 2021 and March 2022 were selected and divided into two groups according to the difference of clinical nursing mode, namely, the experimental group (quality control circle management, n 40 cases) and the control group (traditional management, n 40 cases);The changes of clinical compliance, quality of life, satisfaction and other indicators in the two groups were statistically compared. Results: the compliance, quality of life and satisfaction of the experimental group were better than that of the control group. The data of the two groups were significantly different with statistical advantage (P < 0.05);The complication rate of the experimental group was 7.50%, which was significantly lower than that of the control group (32.50%). The difference was statistically significant (P < 0.05). Conclusion: for the clinical nursing mode of hemodialysis patients, the selection of quality control circle management activities is conducive to reducing the complication rate, improving the quality of life of patients, and greatly improving the satisfaction of patients. Therefore, this nursing management scheme has strong clinical application value.
文摘Objective:This paper aims to investigate the value of individualized care for critically ill patients receiving continuous blood purification therapy.Methods:89 cases of critically ill patients who were treated from June 2021 to June 2023 were randomly divided into groups,with individualized care in group A and routine care in group B.The differences in clinical indicators,purification effect,quality of life,and complications of blood purification were compared between the groups.Results:Heart rate,respiration,body temperature,and other indicators in group A were better than those in group B,P<0.05.C-reactive protein(CRP),β2-microglobulin(β2-MG),blood urea nitrogen(BUN),and phosphorus(P)in group A were lower than those in group B,P<0.05.Group A had higher quality of life than Group B,P<0.05.The complication rate of blood purification in Group A was lower than that in Group B,P<0.05.Conclusion:During continuous blood purification in critically ill patients,individualized nursing intervention can enhance the effect of blood purification,improve the physiological indicators of patients,and reduce the complications of blood purification,which is highly effective and feasible.
文摘Objective: to study the effect of high-quality nursing in blood purification nursing. Methods: a total of 70 patients undergoing blood purification in our hospital from January 2021 to December 2021 were selected and randomly divided into two groups, 35 patients in the observation group (high-quality care) and 35 patients in the control group (routine care). The nursing effects after different nursing methods were compared. Results: compared with the control group receiving routine care, the observation group had a relatively low incidence of complications, good blood biochemical indicators, fewer adverse events and high quality of care (P<0.05). Conclusion: high-quality nursing is very necessary and effective for blood purification center.
文摘Objective: to study the technology of blood purification nursing service quality control and its application effect. Methods: from November 2019 to November 2020, 62 clinical patients who underwent blood purification treatment in the hospital were selected as the main research objects, and randomly divided into two groups by computer, with 31 cases in each group. Routine management mode was given to the reference group and quality control was given to the experimental group. The occurrence state of adverse reactions and the scoring of nursing service quality were compared between the two groups. Results: the incidence of adverse reactions was compared between the two groups. The experimental group was significantly better than the reference group (P < 0.05). Compared with nursing service quality score, the experimental group was significantly better than the control group (P < 0.05). Conclusion: quality control of blood purification nursing can greatly improve the quality of service, reduce the incidence of adverse reactions, and reduce the impact of disease and treatment on patients, which is worthy of promotion and application.
基金supported by the National Key Research and Development Program of China(2021YFC2301805)。
文摘The artificial liver blood purification system(ALBPS),referred to as the artificial liver system,has been extensively used for treatment of patients with liver failure or other organ failures,and its efficacy has been well-documented.To further standardize the clinical application of ALBPS,the Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association and other institutions invited experts to update the 2016 version of ALBPS guidelines and develop the Guidelines on Application of Artificial Liver Blood Purification System(version 2023).In line with the latest international research advancements,this updated version compre-hensively elaborates on various aspects of ALBPS,including treatment mode selection,anticoagulation program implementation,nursing and operational procedures,indications and relative contraindications,common complications and their management,as well as management regulations of the system.These guidelines will provide guidance for the effective application of ALBPS for treatment of critically ill patients.
基金ThisstudywassupportedbyPLATenth Five YearStudyPlan(No 0 1L0 0 7)
文摘Objectives To evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding tendencies. Methods Forty critically ill patients being treated by continuous blood purification (CBP) were involved in this study. Due to their bleeding tendencies, regional citrate anticoagulation treatment was given to all of them. Those with hepatic function impairment (n=10) were classified as Group A, those with hypoxemia were classified as Group B (n=10), and the others as Group C (n=20). Blood samples were collected before treatment, and at 4, 12, 24, 36, and 48 hour intervals during CBP. These samples then were used arterial blood gas analysis, whole blood activated clotting time (WBACT) pre- and post-filter, and serum ionized calcium examination. Results WBACT pre-filter showed little fluctuant through the 48hr period of CBP, and WBACT post-filter showed obvious prolongation than that of the pre-filter (P<0.05) at all time points. Metabolic acidosis was found in Group A patients before CBP, and improved during CBP. Normal acid-base conditions of patients were disturbed and deteriorated in Group B during CBP, but not in Group C. Serum ionized calcium was maintained at a normal range during CBP in Group A and C patients, but declined significantly in Group B patients (vs. pre-treatment, P<0.05). Conclusions Regional citrate anticoagulation can be safely used in conjunction with CBP treatment for patients with hepatic function impairment , but may induce acidosis and a decline in serum ionized calcium when used with hypoxemic patients.
