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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.
RESUMO
@#BACKGROUND: Sepsis and secondary multiple organ failure in critically ill patients are the major cause of death, but the pathogenesis of sepsis is not clear, especially the dysfunction of the immune system. In this paper, we review the response and regulation of the immune system and the functions of a variety of inflammatory mediators in sepsis. DATA SOURCES: Studies were identified by searching MEDLINE and PubMed for articles using the keywords "sepsis", "immune response", and "inflammatory mediator" up to October 2010. Additional papers were identified by a manual search of the references from the key articles. RESULTS: This systematic review was conducted of: 1) the immune response; 2) immune regulation; 3) inflammatory mediators; 4) high-mobility group box 1 protein; 5) the complement system; and 6) the autonomic nervous system. There are no therapeutic approaches available for sepsis that target inflammatory response; the mortality of sepsis has not been significantly reduced. CONCLUSIONS: Sepsis is complex and dynamic, and it has a group of heterogeneous syndromes. Since different patients with sepsis have different etiology, susceptibility, and responses, treatment should be prescribed individually.