Effect of high volume hemofiltration on inflammatory cytokine clearance and hemodynamics in children with sepsis / 中国小儿急救医学

ABSTRACT

Objective To evaluate the effect of high volume hemofiltration (HVHF) treatment on inflammatory cytokine clearance and hemodynamics in children with sepsis.Methods Thirty-four cases of septic children were randomly divided into two groups:the control group(17 cases) was administrated with the routine therapy,while the observation group(17 cases) was underwent with HVHF treatment on the basis of routine therapy.The inflammatory cytokines and hemodynamics were analyzed before and after the treatment.Results (1) Before treatment,the levels of tumor necrosis factor (TNF)-α in the control group and observation group were (103.6 ±26.1) ng/L and (106.6 ±31.6) ng/L,and the levels of interleukin(IL)-6 were (772.8 ± 92.4) ng/L and (761.3 ± 89.2) ng/L,respectively.The concentration of TNF-α and IL-6 were markedly reduced in both two groups after treatment (P ＜ 0.05),with TNF-α and IL-6 reducing to (85.6±23.7) ng/L,(63.6 ±26.4) ng/L and(109.7 ±38.5) ng/L,(78.1 ±24.7) ng/L,respectively.Most importantly,the reduction in the observation group were significantly higher than that in the control group(P ＜ 0.05).(2) Before treatment,no significant differences between the observation group and the control group were observed in hemodynamics,including mean arterial pressure,saturation oxygen,and heart rate(P ＞ 0.05),whereas after the treatment,mean arterial pressure and saturation oxygen in the observation group were significantly elevated compared with those of the control group [(100.4 ± 12.1) mmHg vs.(82.2±11.7) mmHg(l mmHg=0.133kPa),(94.2±5.3)％ vs.(91.4±3.2)％,P＜0.05],andheart rate in the observation group[(85.1 ± 17.3) times/min] was significantly lower than that of the control group [(98.7 ± 18.5) times/min] (P ＜ 0.05).Conclusion HVHF treatment on septic children efficiently promotes the clearance of inflammatory cytokines and improves hemodynamic property,and thereby leads to protection of organ function and the better prognosis for septic children.