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[体外膜肺氧合联合高容量血液滤过治疗多器官功能障碍综合征患者]

[Extracorporeal membrane oxygenation treatment with high-volume hemofiltration in patients with multiple organ dysfunction syndrome].

作者信息

Tao Li-jian, Zhang Jun, Ai Hang-yu, Zhao Shuang-ping, Cai Hong-wen, Ning Jian-ping, Xu Hui

机构信息

Department of Nephrology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2004 Dec;16(12):723-6.

Abstract

OBJECTIVE

To evaluate whether extracorporeal membrane oxygenation (ECMO) with high-volume hemofiltration (HVHF) improves hypoxemia and renal function in patients with multiple organ dysfunction syndrome (MODS).

METHODS

The study was executed in 8 MODS patients with acute respiratory distress syndrome (ARDS) and acute renal failure (ARF). They were randomly assigned to either 8 hours of HVHF combined with ECMO or HVHF alone in random order. The changes in arterial oxygen pressure(PO(2)), pulse oxygen saturation (SpO(2)), arterial carbon dioxide pressure (PCO(2)), serum creatinine (SCr) and blood urea nitrogen (BUN) levels were measured.

RESULTS

Compared with that of before the treatment, PO(2) was increased significantly at 1, 4, 8 hours, and SpO(2) was increased significantly at 4, 8 hours after ECMO with HVHF in MODS patients, the changes of PO(2), SpO(2)and PCO(2)were not significantly during HVHF (all P>0.05). The average concentrations of BUN and SCr were decreased significantly after HVHF or HVHF with ECMO therapy in MODS patients.

CONCLUSION

HVHF with ECMO, which can improve hypoxemia significantly, may be a better option for the treatment of MODS patients.

摘要

目的

评估体外膜肺氧合(ECMO)联合高容量血液滤过(HVHF)是否能改善多器官功能障碍综合征(MODS)患者的低氧血症及肾功能。

方法

该研究纳入8例患有急性呼吸窘迫综合征(ARDS)和急性肾衰竭(ARF)的MODS患者。他们被随机依次分配接受8小时的HVHF联合ECMO治疗或单纯HVHF治疗。测量动脉血氧分压(PO₂)、脉搏血氧饱和度(SpO₂)、动脉血二氧化碳分压(PCO₂)、血清肌酐(SCr)和血尿素氮(BUN)水平的变化。

结果

与治疗前相比,MODS患者在接受ECMO联合HVHF治疗后1、4、8小时PO₂显著升高,4、8小时SpO₂显著升高,而在单纯HVHF治疗期间PO₂、SpO₂和PCO₂的变化不显著(均P>0.05)。MODS患者在接受HVHF或HVHF联合ECMO治疗后,BUN和SCr的平均浓度显著降低。

结论

ECMO联合HVHF能显著改善低氧血症,可能是治疗MODS患者的更佳选择。

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