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
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
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: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
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
Capillary leak syndrome(CLS) in critically ill patients is common,and the clinical manifestations of CLS include systemic edema,hypoproteinemia,effective circulating blood volume reduction and blood concentrated.The c...Capillary leak syndrome(CLS) in critically ill patients is common,and the clinical manifestations of CLS include systemic edema,hypoproteinemia,effective circulating blood volume reduction and blood concentrated.The common pathogenesy is sepsis,severe trauma,cardiopulmonary bypass and so on.CLS is divided into leakage period and recovery period usually.Clinical manifestation and treatment in different period are different in each pathophysiologic process.Although the methods of treatment are more,effective treatment measures are in shortage.More therapeutic measures are studied currently which include improvement of endothelial cell function,macromolecular colloidal solution application,continuous blood purification and so on.It is a guiding value to understand the pathological mechanism,clinical manifestations,diagnosis and treatment of the CLS.展开更多
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。
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: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.
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.
基金Medical Research to Anhui Provincial Health Bureau(09A012)
文摘Capillary leak syndrome(CLS) in critically ill patients is common,and the clinical manifestations of CLS include systemic edema,hypoproteinemia,effective circulating blood volume reduction and blood concentrated.The common pathogenesy is sepsis,severe trauma,cardiopulmonary bypass and so on.CLS is divided into leakage period and recovery period usually.Clinical manifestation and treatment in different period are different in each pathophysiologic process.Although the methods of treatment are more,effective treatment measures are in shortage.More therapeutic measures are studied currently which include improvement of endothelial cell function,macromolecular colloidal solution application,continuous blood purification and so on.It is a guiding value to understand the pathological mechanism,clinical manifestations,diagnosis and treatment of the CLS.
