Influence of continuous renal replacement therapy on prognosis of acute respiratory distress syndrome in early time

Objective To research influence of continuous renal replacement therapy(CRRT) on oxygenation, hemodynamic and prognosis of acute respiratory distress syndrome(ARDS) in early time. Methods 42 patients with ARDS and without renal insufficiency from January 2012 to June 2014 in ICU from Hospital of Traditional Chinese Medicine of Zhongshan City in Guangdong Province were selected and divided into group A(21 patients) and group B(21 patients)according to the random number table method. Group A was treated with conventional treatment, group B was treated with conventional treatment and continuous venous-venous hemofiltration therapy for 72 hours. The respiratory paramater and oxygenation index on the start of treatment(after treatment of 0 h) and after treatment of 24, 48, 72 h between two groups were observed. Changes of hemodynamics were observed by pulse indicator continuous cardiac output at the same time, the illness was evalued by dynamic acute physiology and chronic health evaluation(APACHE) Ⅱscore. Mechanical ventilation time, ICU stay time and 28 d mortality rate between two groups were compared. Results Compared with group A, PEEP after treatment of 72 h was lower in group B(P 0.01), oxygenation index after treatment of 48, 72 h were higher in group B, the differences were statistically significant(all P 0.01). Compared with group A, PCT and lactic acid after treatment of 24, 48, 72 h were lower in group B, the differences were statistically significant(P 0.05 or P 0.01). Compared with group A, CI after treatment of 24, 48, 72 h were higher in group B,EVLWI after treatment of 24, 48, 72 h were lower in group B, the differences were statistically significant(all P 0.01). Compared with group A, APACHE Ⅱ after treatment of 48, 72 h were lower in group B, the differences were statistically significant(P 0.05 or P 0.01). Mechanical ventilation time and ICU stay time in group B were significantly shorter than those in group A, the differences were statistically significant(P 0.01). 28 d mortality rate in group B was lower than that in group A, the difference was statistically significant(P 0.05). Conclusion CRRT for patients with ARDS and without renal insufficiency in early time can remove extravascular lung water and block inflammatory reaction, improve the oxygenation and hemodynamics, reduce mortality rate, improve prognosis significantly.