Clinical effect of continuous renal replacement therapy(CRRT) combined with Bi PAP noninvasive ventilation in the treatment of refractory end-stage heart failure

Objective To explore the clinical effect of continuous renal replacement therapy(CRRT) combined with Bi PAP noninvasive ventilation on refractory end-stage heart failure.Methods Three hundred patients cases with refractory end-stage heart failure were divided into two groups according to different treatment in our hospital.All of them were given standard drug.In control group,143 patients were given Bi PAP,while in research group,157 patients were given CRRT combined with Bi PAP.The vital signs,NT-pro-BNP,LVEF,CRE,Pa O2 and effect were observed and compared before and after treatment in the two groups.Results Compared to before treatment,the values of NT-pro-BNP after treatment significantly decreased in both control group and research group [(1 996±63.7) pg/ml vs(875±29.4) pg/ml,(2 096±62.8) pg/ml vs(565±30.0) pg/ml,respectively,P0.01].The effect was better in research group.After treatment,the Pa O2 in both groups were statistically significantlyincreased than those before treatment[(87.5 ± 2.94) mm Hg vs(69.96 ± 6.37) mm Hg,(92.5 ± 3.00) mm Hg vs(68.86 ± 6.28) mm Hg,respectively,P0.01].After treatment,the CRE in both groups were statistically significantly decreased than those before treatment[(199.6 ± 63.7) μmol/L vs(87.5 ± 2.94) μmol/L,(198.6 ± 62.8) μmol/L vs(76.5 ± 3.00) μmol/L,respectively,P0.01).There was a statistically significant difference between the two groups(P0.05).The effective rate of the change on dropsy and exudation on rabat and heart doppler ultrasound,the effective rate on the dyspnea,heart function classification and mobility and the survival rate in the research group were statistically significantly higher than those in the control group(84.7% vs 71.3%,82.8% vs 69.9%,86.0% vs 76.9%,respectively,P0.05).Conclusion CRRT combined with BiPAP noninvasive ventilation could effectively relieve the clinical symptoms,improve the heart function,increase the rate of escue success,which is a positive,safety and efficient treatment.