The Study On Clearance Effect Of Continuous Renal Replacement Therapy On Cytokines In Patients With Sepsis

Objective : To investigate whether continuous renal replacement therapy(CRRT)can clear cytokines in septic patients and its effect on prognosis,to calculate the clearance of each cytokine and to investigate whether cumulative fluid balance correlates with the concentrations of cytokines.Methods:A total of 33 patients with sepsis who were admitted to ICU from May 2022 to September 2022 were divided into two groups,the patients of control group received conventional standard treatment and the patients of experimental group received CRRT in addition.The plasma samples were collected at 0h,24 h,72h and 7d after admission of two groups,the plasma and filtrate samples were collected at 4h after CRRT of experimental group.The concentrations of IL-1,IL-2,IL-6,IL-8,IL-10 and TNF-a were measured and compared between two groups,calculate the clearance of each cytokine.Make correlation analysis between cumulative fluid balance and cytokine concentrations and statistical analysis was performed for prognosis.Results:1.The general clinical informations of two groups had no statistical difference except for creatinine and urea(p>0.05).2.The cytokine concentrations of two groups at baseline were not statistically different(p>0.05),the concentrations of IL-1 and IL-2 in the experimental group were lower than those in the control group after 24 h of treatment(p=0.007,p=0.005),the concentration of IL-6 in the experimental group was higher than that in the control group after 72 h of treatment(p=0.010).The concentrations of IL-2,IL-6,IL-8 and IL-10 in the experimental group showed a continuous decline trend after24 h,72h and 7d of treatment.3.The solute clearance of IL-6 was 5.30[4.83,6.63]ml/min.4.There was no correlation between the cumulative fluid balance and the concentration of each cytokine in the experimental group.5.There was no statistical difference in the duration of mechanical ventilation,duration of ICU or 28-day mortality between two groups(p=0.504,p=0.748,p=0.619).Conclusions:1.CRRT can clear the circulated cytokines in septic patients,the clearance of IL-6 can be calculated,but the effect of clearing cytokines was limited.2.Cumulative fluid balance of CRRT did not correlate with cytokine concentrations.3.No significant improvements were observed in duration of mechanical ventilation,duration of ICU or28-day mortality compared with the control group.