持续静脉-静脉血液滤过对危重症甲型H1N1流感患者呼吸功能的影响

目的 探讨持续静脉-静脉血液滤过(CVVH)对危重症甲型H1N1流感患者呼吸功能的影响.方法 通过对入选的10例甲型H1N1流感危重症患者在常规治疗的基础上联合应用CVVH治疗,分别观察干预前及干预后24 h、48 h、72 h、120 h的血清炎性介质水平肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、IL-8...

Effects of continuous veno-venous hemofiltration on respiratory function of critical patients with influenza A/H1N1

Objective To explore the effects of continuous veno-venous hemofiltration (CVVH) on respiratory function of critical patients with influenza A/H1N1. Methods Ten cases of influenza A/H1N1 eceived CVVH on the basis of conventional therapy. Before and at 24th, 48th, 72nd, 120th hour after intervention, serum inflammatory mediators tumor necrosis factor-α (TNF-α) ,interleukin-6 (IL-6), IL-8,IL-10], respiratory mechanics indexes (airway pressure, static compliance, oxygenation index),extravascular lung water, blood gas analysis indexes (PaO2, PaCO2, pH) and APACHE Ⅱ score were determined. Results Compared with before CVVH intervention, TNF-α, IL-6, IL-8 in blood at 72th,120th hour after intervention were significantly decreased ( P ＜0.05). There was statistical significance on airway pressure, static compliance, oxygenation index between before CVVH intervention and at 72th hour after intervention ( P ＜0.05). Extravascular lung water gradually declined from 48th hour after intervention ( P ＜0.05). Compared with before treatment, PaO2, PCO2 improved at 72th hour after intervention ( P ＜0.05). Oxygenation index improved at 48th hour after intervention ( P ＜0.05), and had been stable at normal level at 72th hour after intervention. Meanwhile, APACHE Ⅱ score decreased at 72th hour after intervention ( P ＜0. 05). Conclusions For critical patients with influenza A/H1N1,CVVH can remove some inflammatory mediators and extravascular lung water, improve respiratory function, and increase the success rate of rescue.