Comparison of therapeutic effect of two types of blood purification on patients with severe acute organophosphate poisoning combined with myocardial injury / 中华急诊医学杂志

ABSTRACT

Objective To compare therapeutic effect of single hemoperfusion and hemoperfusion combined with continuous veno-venous hemofiltration ( sequential continuous blood purification) on patients with severe acute organophosphate poisoning combined with myocardial injury.Methods A total of 80 patients with severe acute organophosphate poisoning combined with myocardial injury admitted to EICU of Beijing Chaoyang Hospital from Jan.2004 to Dec.2013 were respectively analyzed and divided into two groups hemoperfusion group (patients collected from Jan.2004 to Dec.2008, n=41) and sequential continuous blood purification (patients collected from Jan.2009 to Dec.2013, n =39).The average cholinesterase recovery time, the average consciousness recovery time, the average doses of atropine, the average hospital time, the change of cardiac troponin I levels on days 1, 2, 3, 5 and 7 after admission, and the change of left ventricular ejection fraction within 24 h after admission and after 24 h following blood purification treatment were compared between the two groups.Results Patients in the sequential continuous blood purification group had less average cholinesterase recovery time, average consciousness recovery time, average doses of atropine and average hospital time compared with patients in the hemoperfusion group [ ( 87.6 ±8.8 ) h vs.( 113.8 ±13.3 ) h;(57.3 ±11.7) h vs.(100.5 ±10.8) h;(284.5 ±61.4) mg vs.(476.6 ±93.1) mg and (10.2 ±2.3) vs. (14.6 ±3.9) , all P<0.01].The levels of cardiac troponin I on days 2, 3, 5 and 7, and ejection fraction of left ventricule after 24 h following blood purification treatment in the sequential continuous blood purification group were significantly decreased compared with patients in the hemoperfusion group ( all P <0.05 ) . Conclusion Therapeutic effect of sequential continuous blood purification on patients with severe acute organophosphate poisoning combined with myocardial injury is superior to single hemoperfusion.It suggests that sequential continuous blood purification could be used as a preferred choice in treatment of patients with severe acute organophosphate poisoning combined with myocardial injury.