Clinical effects and safety of continuous high-volume hemofiltration on severe sepsis patients with multiple organ dysfunction syndrome

Objective To observe the clinical effects and safety of continuous high-volume hemofiltration(HVHF) on severe sepsis with multiple organ dysfunction syndrome(MODS).Methods From 2005 to 2007,20 severe sepsis patients with MODS whose average APPACHEⅡ score was 23.8±8.3 and SOFA score was 10.6±4.0 underwent continuous HVHF therapy besides the common treatments.The blood flow rate was 250 mL/min and ultrafiltration rate was 4L/h,and the substitute fluid was infused with predilution.The unfractionated heparin was used for anticoagulation.The hemofilter was changed per 24h.The vital signs,blood urea nitrogen,creatitine,platelet,bilirubin,arterial lactic acid,oxygenation index,APPACHEⅡ and SOFA score of the patients were measured and compared before and after HVHF therapy.During HVHF therapy,the complications were monitored.Results The vital signs of the patients became stable shortly after HVHF therapy with a decrease in temperature,respiratory rate and heart rate while an increase in mean arterial pressure.The level of blood urea nitrogen,creatitine,arterial lactic acid decreased,the count of platelet increased and the oxygenation index improved after HVHF therapy compared with those before treatment(P0.05).The same thing occurred in APPACHEⅡ score and SOFA score.But the serum bilirubin level did not changed during HVHF therapy.Conclusion HVHF therapy could decrease the systemic inflammation reaction of severe sepsis patients with MODS and improve organ function without any severe complications.