A Meta-analysis Of The Efficacy Of Continuous Renal Replacement Therapy For Burns And Sepsis

Objective:To analyze the short-term therapeutic effect of continuous renal replacement therapy(CRRT)on burn sepsis,provide a powerful basis for guiding clinicians in the treatment of burn sepsis.Methods:Computer Search PubMed,MEDLINE,Embase,Cochrane Library,CNKI,Wanfang and VIP databases approach before November 2018 of literature of randomized controlled trials of patients with burn sepsis using CRRT plus conventional therapy versus conventional therapy.According to the strict inclusion criteria,two researchers separately screened the literature,then carried out the quality assessment of the included literature and effective data extraction,and finally collected the data using the latest version of Review Manager5.3 software for meta-analysis.Results:A total of 13 articles of randomized controlled trials with an English to Chinese ratio of 1/12 were included in the study.A total of 667 patients of the ratio of CRRT to control group was 326/341 were included in the study.Meta-analysis showed that CRRT group was better than the control group in compare the short-term efficacy of patients with burn sepsis.The short-term efficacy about the degree of decrease of leukopenia before and after treatment [SMD=-1.11,95% CI(-1.40,-0.83),P<0.00001];the degree of decline of procalcitonin [MD=-4.66,95% CI(-8.96,-0.35),P=0.03];the degree of decrease in blood urea nitrogen concentration [SMD=-1.10,95% CI(-1.67,-0.53),P<0.00001 ];the degree of decrease in serum creatinine concentration[SMD=-0.82,95% CI(-1.16,-0.48),P<0.00001];the degree of decline in blood glucose concentration [MD=-2.75,95% CI(-4.52,-0.98),P=0.002];the degree of decrease of serum sodium ion concentration [MD=-11.43,95% CI(-15.71,-7.16),P<0.00001];the degree of increase of arterial oxygen partial pressure [MD=0.70,95% CI(0.42,0.99),P < 0.00001];the degree of decrease in plasma IL-6concentration [SMD =-3.78,95% CI(-5.11,-2.45),P < 0.00001];the degree of decrease in plasma IL-8 concentration [SMD =-2.52,95% CI(-3.41,1.63),P<0.00001];the degree of decrease in plasma TNF-? concentration [SMD =-2.84,95% CI(-3.86,-1.82),P <0.00001].Conclusion:CRRT treatment is superior to conventional treatmentin in comparing the degree of decline in each of the above outcomesis.Research indicating that CRRT treatment can improve the clinical short-term efficacy of patients with burn sepsis.However,the above results still need more high-quality large-scale research experiments at home and abroad to verify.