Timing of continuous veno-venous hemofiltration for patients with wasp sting-induced multiple organ dysfunction syndrome of different phases according to RIFLE criteria / 第二军医大学学报

ABSTRACT

Objective To analyze the efficacy of continuous veno-venous hemofiltration (CVVH) for patients with wasp sting-induced multiple organ dysfunction syndrome (MODS) at different phases according to RIFLE criteria. Methods The clinical data of 61 patients with wasp sting-induced MODS, who were treated in Chengdu General Hospital, Southwest Hospital and Xinqiao Hospital during Jan. 2006 to Dec. 2010, were retrospectively analyzed. Sixteen patients who were not treated with CVVH were taken as controls. Another 45 patients with acute kidney injury(AKI) were divided into 3 groups group A (AKI I), group B(AKI II) and group C (AKI III) according to the RIFLE criteria; the timing of CVVH was analyzed according to different phases of AKI. The mortality rate in hospital, length of ICU stay, duration of total mechanical ventilation, length of CVVH, and the intervals between wasp sting and CVVH were compared among different groups. Their APACHE II scores, sequential organ failure assessment (SOFA) scores, serum interleukin-6 (IL-6), oxygenate index, serum creatinine (Cr), and mean arterial pressure(MAP) were compared before and 24 h after CVVH. Resutts (1)The mortality rate in the control group was significantly higher than that in therapeutic group(P0.05), but serum IL-6 in group B was significantly higher than that in group A(P0.05). Conclusion CVVH is an effective treatment for patients with wasp sting-induced MODS. RIFLE criteria can help to guide the timing of CVVH. CVVH can remarkably improve the prognosis of patientswith phase I and II AKI afterwasp sting-induced MODS, with the best efficacy seen in patient with phase I AKI.