Sequential hemoperfusion and continuous veno-venous hemofiltration in treatment of severe organophosphorus pesticide poisoning

Objective:To investigate the effects of sequential hemoperfusion(HP) and continuous veno-venous hemofiltration(CVVH)on severe organophosphorus pesticide poisoning and its mechanism.Methods: Eighty eight patients with acute severe organophosphorus pesticide poisoning were divided into two groups,the control group was treated with conventional combined therapy and HP,while the observation group was also given the sequential HP and CVVH based on the conventional treatment.The cure rates and related clinical indicators and levels of TNF-α,IL-1β,IFN-γ and IL-4 were observed and compared between the two groups.Results:After treatment,the cure rate of the control group and observation group was 85.71%(18/21) vs.91.30%(21/23),respectively showing no significant difference between the two groups(P0.05).Length of coma and 60% CHE activity recovery time,ICU stay,as well as hospitalization time of the observation group were significantly shorter than that of the control group,the difference was statistically significant(P0.05).Before treatment,no significant difference in levels of serum TNF-α,IL-1β,IFN-γ and IL-4 were found between the two groups;after 24 h of treatment,the levels of the above mentioned inflammatory mediators were significantly reduced(P0.05),and those levels of observation group were lower than that of the control group(P0.05).Conclusion:Sequential hemoperfusion and continuous veno-venous hemofiltration can improve symptoms of severe organophosphate poisoning by reducing inflammatory mediators levels.