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Therapeutic effects of continuous renal replacement in patients with multiple organ dysfunction syndrome in ICU

Keywords: renal replacement therapy , sepsis , multiple organ failure , mortality

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Abstract:

Objective  To investigate the effects of continuous renal replacement therapy (CRRT) on patients with multiple organ dysfunction syndrome (MODS). Methods  Forty-seven patients with MODS, admitted to the Department of SICU of First Affiliated Hospital of General Hospital of PLA, were divided into two groups according to the causative agents: the sepsis group (n=28) and the non-sepsis group (n=19). All the patients involved were treated with CRRT therapy. The systemic and brain hemodynamic parameters, and oxygenation and metabolic variables were assessed immediately before and 12 hours after CRRT. The expected mortality was obtained by APACHE Ⅱ score, and it was compared with the actual mortality to obtain the standard mortality, of which less than 0.9 was defined as an improved survival rate. Results  After 12 hours of CRRT treatment, all the variables (except mean arterial pressure and brain hemodynamics) were significantly improved in the sepsis group (P<0.05). The survival rate in ICU was 60.7% with a standard mortality of 0.70. In the non-sepsis group, the survival rate in ICU was only 15.8% and the standard mortality was 1.77. Only the FiO2 was found to be significantly improved in the non-sepsis group. Conclusion  CRRT may significantly improve the clinical outcome and survival rate of patients with sepsis-caused MODS, but no obvious effect is found among the patients with MODS caused by non-sepsis factors.

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