危重症患者行连续性肾脏替代治疗时细胞因子的清除。

Cytokine Clearances in Critically Ill Patients on Continuous Renal Replacement Therapy.

机构信息

Department of Medicine, Section of Transplant Nephrology, Division of Nephrology, University of California, Sacramento, California, USA.

Department of Nephrology and Hypertension, Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Blood Purif. 2018;46(4):315-322. doi: 10.1159/000492025. Epub 2018 Aug 14.

DOI:10.1159/000492025

PMID:30107381

Abstract

BACKGROUND/AIMS: We sought to quantify any differences in cytokine clearance between continuous venovenous hemofiltration (CVVH-convective) compared to continuous venovenous hemodialysis (CVVHD-diffusive).

METHODS

We conducted a 20 patient, multicenter, prospective, open-label randomized trial (CVVH or CVVHD) at continuous renal -replacement therapy (CRRT) initiation. Blood, urine, and effluent were collected at 0, 4, 24, and 48 h after initiation of CRRT. Serum electrolytes, cytokines levels, and clearances were measured. Cytokines studies included IL-1β, IL-1RA, IL-6, IL-10, and TNFα.

RESULTS

We randomized 20 patients to receive CRRT. After 4 h of CRRT there was no difference in total cytokine levels or change in cytokine concentrations across the 2 groups. With the exception of IL-1 RA, all cytokines levels decreased across patient groups regardless of modality. There was no significant difference in cytokine concentration across CRRT modality for any time point.

CONCLUSION

Within the first 4 h of CRRT initiation, there is no significant difference between cytokine or solute clearance between CVVH and CVVHD.

摘要

背景/目的：我们旨在量化连续静脉-静脉血液滤过（CVVH-对流）与连续静脉-静脉血液透析（CVVHD-弥散）之间细胞因子清除的任何差异。

方法

我们在连续肾脏替代治疗（CRRT）开始时进行了一项 20 例患者、多中心、前瞻性、开放标签随机试验（CVVH 或 CVVHD）。在 CRRT 开始后 0、4、24 和 48 小时收集血液、尿液和流出液。测量血清电解质、细胞因子水平和清除率。细胞因子研究包括 IL-1β、IL-1RA、IL-6、IL-10 和 TNFα。