Continuous Blood Purification Ameliorates Hypermetabolism Of Critical Patients

Objective:This study is designed to investigate the clinical effect of continuous blood purification (CBP) on resting energy metabolism of critically ill patients with systemic inflammatory response syndrome (SIRS).Methods:29 SICU patients with SIRS and the indication of CBP therapy were enrolled. Predictive and actual rest energy expenditure (REE) was measured by indirect calorimetry equipment before CBP (0h),24h and 48h after CBP, respectively. At the same time, the levels of stress hormones (epinephrine and cortisol), proinflammatory cytokines (IL-6, IL-8), anti-inflammatory cytokines (IL-4, IL-10) were assayed. The other parameters such as blood routine test, nutrition support protocols, and vital signs were also recorded. Results:REE results of critically ill patients with SIRS were significantly higher than the patients without SIRS. At the time points of 24h and 48h after CBP, REE significantly decreased (p<0.05) compared with that at Oh. The concentrations of stress hormones (epinephrine and cortisol) were lower than those before CBP. The levels of IL-6 and IL-10 were significantly decreased (p<0.05), while the levels of IL-4 and IL-8) had no significant difference.Conclusion:CBP therapy is effective in eliminating some stress hormones and inflammatory mediators, which improves the hypermetabolic situation of critically ill patients.