Yang Yang, Liu Enhe, Zhang Xijian, Wang Lichun, Chen Lei
Department of Critical Care Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
Heliyon. 2024 Apr 29;10(9):e30463. doi: 10.1016/j.heliyon.2024.e30463. eCollection 2024 May 15.
Fournier's gangrene (FG) is a severe form of necrotizing fasciitis primarily caused by gram-negative bacteria. FG can rapidly progress to septic shock, resulting in high mortality rates. In the past, the management of the inflammatory response caused by gram-negative bacteria has been limited. Continuous Veno-Venous Hemofiltration with oXiris hemofilters (oXiris-CVVH) has shown promise in adsorbing inflammatory factors and endotoxins, making it an attractive approach for treating FG. This study aims to provide insights into the characteristics of patients with FG and septic shock who have been successfully treated using oXiris-CVVH, based on a series of patient cases.
This study presents the management of 4 cases in the intensive care units of a tertiary hospital in southern China. The use of oXiris-CVVH in patients with septic shock and FG yielded valuable practical insights.
Based on the experience gained from these 4 cases, the utilization of oXiris-CVVH demonstrated potential in reducing the Sequential Organ Failure Assessment (SOFA) score, improving prognosis, and effectively lowering the levels of lactic acid and procalcitonin (PCT) in the blood. Additionally, it facilitated a reduction in the dosage of noradrenaline. Therefore, oXiris-CVVH should be considered as an adjunctive therapy in the treatment of patients with FG and septic shock.
福尼尔坏疽(FG)是一种主要由革兰氏阴性菌引起的严重坏死性筋膜炎。FG可迅速发展为感染性休克,导致高死亡率。过去,革兰氏阴性菌引起的炎症反应的管理一直有限。使用oXiris血液滤过器的持续静脉-静脉血液滤过(oXiris-CVVH)在吸附炎症因子和内毒素方面显示出前景,使其成为治疗FG的一种有吸引力的方法。本研究旨在基于一系列患者病例,深入了解使用oXiris-CVVH成功治疗的FG和感染性休克患者的特征。
本研究介绍了中国南方一家三级医院重症监护病房4例患者的治疗情况。在感染性休克和FG患者中使用oXiris-CVVH产生了宝贵的实践经验。
基于这4例患者的经验,使用oXiris-CVVH在降低序贯器官衰竭评估(SOFA)评分、改善预后以及有效降低血液中乳酸和降钙素原(PCT)水平方面显示出潜力。此外,它有助于减少去甲肾上腺素的用量。因此,oXiris-CVVH应被视为治疗FG和感染性休克患者的辅助治疗方法。