The Application Of Hemofiltration In Treatment Of Critically Ill Patients In Intensive Care Unit

Most of the diseases in the intensive care unit (ICU) such assevere acute pancreatitis (SAP), acute poisoning, acute renal failure(ARF), acute heart failure and multiple organ disfunction syndrome(MODS), offen have a strong threaten of patients' lives, because ofone or more organs' suffering from severe injuries. Hemofiltration(HF) has been used in clinical works for more than 20 years, and itsadvantages have been recognized more and more clearly as the studiesgo on. Our hospital has use this technology in ICU since 2002 and hasgot good results. In order to determine wheather and how much theHF can improve the prognoses of critically ill patients, we analysis thedatas of patients in ICU from May, 2002 and October 2005, whichwas expected to give proper advises in clinical daily work. There are 23 critically ill patients in total. 19 of them recovered,1 gave up and 3 died after HF. All patients' temperature fell down aftertreatment. 14 patients had consciousness problems and 12 of themrecovered in the course of or in 1-2 days after HF;9 in 12 ARFpatients' urinary volume increased and renal function recoveredgradually after HF;6 in 9 mechanical ventilation patients got rid of itin 1-7days after HF;the symptoms of dyspnea improved;1 in 4patients' need of doses of dopamine decreased;3 AHF patients'symptoms improved and the wet rale disappeared. Also the level ofelevanted NE, AST and ALT, CRE, BUN and AMS decreasedsignificantly in analysis (p<0.05).This research indicate that HF may decline the level of infectiousreaction, protect the organs from severe injury, adjust the balance ofinternal environment and offer the space for nutrition support, whichplays an important role in treatment of severe ill patients.However, there are still arguments on the question of wheatherHF can improve the prognosis of diseases as mentioned before. Mostof researches shows that it indeed can, but other researchers considerthat in MODS, if the patients have 3or more organs disabled, HF onlycan prolong the living times but no significant change of prognosis.For example, some data show that the mortality of SAP is about20%-25% generally, while in our research, the mortality after HF fellto 19.67%, indicate that HF can decreased the mortality of SAP. Butthere are only 6 cases of SAP in total, so, we need further research tomake sure of this question.In total, HF plays an important role in ICU daily work. As theresearch of its mechanism and further prognosis goes deeply, it mayget more and more widely application, and the results of correlatedresearch will guide clinical work corectly.