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Objective To investigate the treatment of septic shock(SS) from upper urinary obstruction(UUO). Methods Continuous veno-venous haemofiltration(CVVH) combined with surgical method was applied to 42 SS patients from UUO. Their general conditions, liver and kidney functions, APACHE Ⅱ, therapeutic intervention scorisystem(TISS), multiple organ dysfunction syndrome (MODS), complication rate and main outcomes were analysed comparing with traditional therapies groups(n=30). Results Compared with those traditional therapies, the APACHEⅡ , MODS and TISS score decreased (P＜0.05). Thirty-seven out of 42 patients survived and the survival rate was 88.0% during ICU. Conclusion CVVH combined with surgical methods may effectively decrease the incidence of complications and mortality of SS from UUO, and the mechanism may be related to the remove of mediators of inflammation.
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Objetivo: La ultrafiltración (UF) convencional es la técnica por la que el plasma ultrafiltrado es obtenido a través de una membrana semipermeable durante la circulación extracorpórea (CEC). Se realizó este estudio para describir el efecto de la UF convencional sobre algunas variables hematológicas. Metodología: Estudio descriptivo, retrospectivo con 23 pacientes con UF y 94 pacientes no UF sometidos a CEC. Resultados: Los procedimientos quirúrgicos y comorbilidades fueron similares en ambos grupos. El TPT preoperatorio fue comparable en ambos grupos, mientras que el postoperatorio fue mayor en los no UF. El INR no tuvo cambios significativos. Hemoglobina y hematocrito disminuyeron en la medición postbomba y aumentaron a las seis horas en UF. Los tiempos de bomba y de pinza y el balance de sangrado a las seis horas fueron levemente mayores en UF. Dos pacientes del grupo no UF fueron reintervenidos. No hubo diferencias en el tiempo de estancia en cuidado intensivo. Conclusiones: La UF no produce alteración significativa en las variables hematológicas. [Cañas M, Duarte YM, Ochoa FL, Díaz AM. Variables hematológicas en pacientes con ultrafiltración en circulación extracorpórea. MedUNAB 2008; 11: 206-212].
Purpose: Ultrafiltration (UF) is the conventional technique of plasma ultrafiltered is obtained through a semipermeable membrane during cardiopulmonary bypass. We performed this study to describe the effect of conventional UF on some hematologic variables. Methodology: this is a descriptive and retrospective study: 23 patients with UF and 94 patients without UF subjected to CEC. Results: surgical procedures and comorbidities were similar in both groups. The preoperative PTT in non UF group was more prolonged, and no changes in the postoperative period. Preoperative TP was comparable in both groups, while the postoperative was higher among non UF group. The INR had no significant changes. Hemoglobin and hematocrit fell in measuring post-pump and rose at 6 hours in UF group. Cardiopulmonary bypass and aortic cross-clamp times and amount of bleeding at 6 hours were slightly higher at UF group. Two patients of the non UF group required re-exploration. There was no difference in the length of stay in intensive care. Conclusions: UF did not change significantly the hematologic variables. [Cañas M, Duarte YM, Ochoa FL, Díaz AM. Hematological variables in patients with ultrafiltration during cardiopulmonary bypass. MedUNAB 2008; 11: 206-212].