[Effect of early continuous blood purification on the prognosis of children with septic shock: a prospective randomized controlled clinical trial].

医学 感染性休克 休克(循环) 前瞻性队列研究 机械通风 尿 随机对照试验 B组 麻醉 败血症 内科学 胃肠病学 外科
作者
Youjun Xie,Wugui Mo,Yue Wei,Rong Wei,Yu-Peng Tang,Zhuo Li,Gongzhi Lu,Zhi-Rong Mo
出处
期刊:PubMed 卷期号:22 (6): 573-577
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摘要

To study the effect of early continuous blood purification (CBP) on the prognosis of children with septic shock.A prospective analysis was performed for the children with septic shock who did not reach the 6-hour initial recovery target and/or had a fluid overload of >10%. According to the treatment time of CBP, they were divided into an early group with 30 children and a conventional group with 28 children. The two groups were compared in terms of the start time of CBP and 28-day mortality rate, as well as the related indexes in the children who were cured.The early group had a significantly earlier start time of CBP than the conventional group (P<0.05). There were 25 children cured in the early group and 22 cured in the conventional group, and there was no significant difference in 28-day mortality rate between the two groups (P>0.05). The children who were cured in the early group had significantly shorter correction time of lactic acid, urine volume, and fluid overload than those in the conventional group (P<0.05). The children who were cured in both groups had significant reductions in the percentages of T-lymphocyte subsets at the beginning (P<0.05); on reexamination on day 7, the percentages of T-lymphocyte subsets were increased and were higher in the early group than in the conventional group (P<0.05). The children who were cured in the early group had significantly shorter duration of CBP treatment, duration of mechanical ventilation, and length of stay in the PICU than those in the conventional group (P<0.05).For children with septic shock who do not reach the 6-hour initial recovery target and/or have a fluid overload of >10%, early CBP treatment can quickly control the disease, shorten the course of disease, and accelerate immune reconstruction.

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