| Objective: To observe the effect and result of hemofiltration and plasma exchange on clearing endotoxin and biochemical markers in human sepsis. Methods: Thirty patients meet the entry criteria were randomized to three group , A group(n=12), B group(n=12) and C group(n=6).Patients of A group were treated by hemofiltration for 6 hrs/person each time. B group were given plasma exchange at 3000mL each time. The two group were accompanied with conventional medical therapy and the only treat to C group.Blood samples were collected to assay the number of neutrophils, LDH, CK, CK-MB, BUN, Cr, TBIL, GOT, GPT, PLT, TP, ALB,GLO at 0' and 6 hrs after treated in A,B group. Record the APACHE II, the number of organs failing at admission and 3 days later and the outcome at 14 days to estimate the effect of therapy. The concentrations of endotoxin in the blood and ultrafiltrate at 0' and 2hrs after the therapies were measured in A,B group. Result: The blood concentration of TBIL, GOT, GPT, LDH, CK, CK-MB, BUN, Cr decreased significantly after therapies in A,B group. APACHE II and the number of organs failing of A,B group reduced in compare to control group. The blood concentrations of endotoxin at 0' and 2hrs after therapies were no difference and no endotoxin was detected in the ultrafiltrate. But in B group, the concentrations of endotoxin was lower at 2hrs after therapy than at 0' and some endotoxin was detected in the ultrafiltrate. The death rate of 14 days was lower in A group but no difference in B group in comparison with C group. Conclusion: Plasma exchange can reduce the blood concentrations of endotoxinsignificantly and and result in decreased inflammatory mediators production and making all kinds of biochemical markers lower. Hemofiltration can clear some medium-molecule substance such as some inflammatory mediators rather than endotoxin. Both therapies can reduce the number of organs failing and improve clinic condition. Hemofiltration can decrease mortality. |
PDF Full Text Request