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将oXiris生物吸附滤器纳入连续性肾脏替代治疗(CRRT)用于治疗严重腹部感染及早期撤机相关危险因素分析

Incorporation of oXiris Bioabsorbent Filter into CRRT in the treatment of severe abdominal infections and analysis of associated risk factors for early off-machine.

作者信息

Dong Yanfang, Chen Jieling, Zhang Xiaoli, Wu Shiyu, Li Yiming, Zhang Qiaoxian

机构信息

Department of Emergency Intensive Care Unit, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.

Department of Nursing, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.

出版信息

Front Public Health. 2025 Jul 30;13:1560587. doi: 10.3389/fpubh.2025.1560587. eCollection 2025.

Abstract

INTRODUCTION

This study aims to evaluate the impact of oXiris continuous renal-replacement therapy (CRRT) on the prognosis of patients with severe intra-abdominal infections (IAIs) and to analyze potential risk factors for early off-machine of oXiris CRRT during treatment.

METHODS

A total of 49 patients with severe abdominal infections admitted to the intensive care unit of the First Affiliated Hospital of Fujian Medical University from October 2020 to October 2023 were retrospectively analyzed. The patients were divided into a conventional group and an oXiris group. Heart rate, blood lactate level, mean arterial pressure, and total CRRT operation time were observed 72 h before and after CCRT treatment.

RESULTS

When comparing changes in indicators over the 72-h period between the two groups, no significant difference in survival rate was observed between the two groups. D-dimer [per 1 ng/mL increase, odds ratio (OR) = 0.930, 95% confidence interval (CI): 0.866-0.999] was identified as a risk factor for early off-machine. In contrast, prothrombin time (PT, per 1-s increase, OR = 1.117, 95% CI: 1.017-1.226), activated partial thromboplastin time (APTT, per 1-s increase, OR = 1.021, 95% CI: 1.006-1.037), and blood flow velocity (per 1 mL/min increase, OR = 1.027, 95% CI: 1.009-1.046) were found to be protective factors.

CONCLUSION

oXiris CRRT is associated with a better prognosis in the treatment of severe abdominal infections. APTT, PT, D-dimer, and blood flow velocity are associated with early off-machine during oXiris CRRT.

摘要

引言

本研究旨在评估oXiris连续性肾脏替代治疗(CRRT)对严重腹腔内感染(IAIs)患者预后的影响,并分析治疗期间oXiris CRRT早期撤机的潜在危险因素。

方法

回顾性分析2020年10月至2023年10月福建医科大学附属第一医院重症监护病房收治的49例严重腹腔感染患者。将患者分为传统组和oXiris组。在CCRT治疗前后72小时观察心率、血乳酸水平、平均动脉压和CRRT总操作时间。

结果

比较两组72小时内指标变化时,两组生存率无显著差异。D-二聚体[每增加1 ng/mL,比值比(OR)=0.930,95%置信区间(CI):0.866-0.999]被确定为早期撤机的危险因素。相比之下,凝血酶原时间(PT,每增加1秒,OR=1.117,95%CI:1.017-1.226)、活化部分凝血活酶时间(APTT,每增加1秒,OR=1.021,95%CI:1.006-1.037)和血流速度(每增加1 mL/min,OR=1.027,95%CI:1.009-1.046)被发现是保护因素。

结论

oXiris CRRT在严重腹腔感染治疗中与较好的预后相关。APTT、PT、D-二聚体和血流速度与oXiris CRRT期间的早期撤机有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c7/12343586/bbdcabc71f48/fpubh-13-1560587-g001.jpg

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