The Effects of High-volume Hemofiltration by Different Ultrasound Directing on Extra Vascular Lung Water Index in Patients with Septic Shock

  • Hongsheng REN Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Bo SONG Dept. of Intensive Care Unit, Taishan Medical University Affiliated Zouping Hospital, Zouping, China
  • Pengcheng LI Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Cheng HUAN Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Yufeng CHU Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Min DING Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Yuping WANG Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Qingchun YAO Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Peng WANG Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Guoqiang QI Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
  • Chunting WANG Dept. of Intensive Care Unit, The Provincial Hospital Affiliated to Shandong University, Jinan, China
Keywords: Critical bedside ultrasound, Septic shock, High-volume hemofiltration

Abstract

Abstract Background: We explored the effects of high-volume hemofiltration(HVHF) by different ultrasound directing on the plasma N-terminal pro-B-type natriuretic peptide(NT-Pro-BNP), extra vascular lung water index (EVLWI), liquid net balance quantity and prognosis in patients with septic shock. Methods: Overall, 107 intensive patients with septic shock were enrolled by retrospective analysis from Department of Intensive Care Unit (ICU) of the Shandong Provincial Hospital affiliated to Shandong University from 2014-2017. According to HVHF by different ultrasound directing, all the patients were divided into two groups ((ultrasonic cardiac output monitor (USCOM), group A, n=51cases)) and ((critical bedside ultrasound (CBU), group B, n=56cases)). Results: The value of CI in group A had a significant positive correlation with the value of PCCI by the PiCCO2 monitoring (P<0.05). The lung ultrasound water B lines in group B also had a significant positive correlation with the value of EVLWI by the PiCCO2 monitoring. The cumulative liquid net balance quantity in group B had a more significant elevation than group A after treatment 7th d. The level of EVLWI after treatment 48 h and 72 h, the level of plasma NT-Pro-BNP, the levels of P(A-a)DO2,OI and blood lactic after treatment 72 h, and the APACHEⅡ scores and SOFA scores after treatment 7thd were reduced more significantly in group B than group A (P<0.001). The mortality at 28th day had a more significant decrease in group B than group A. Conclusion: It could decrease the level of NT-Pro-BNP, EVLWI, P(A-a)DO2,which then improves pulmonary oxygenation. Consequently, it decreased the APACHEⅡand SOFA scores and improved the 28th survival rate of patients.  

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Published
2018-08-29
How to Cite
1.
REN H, SONG B, LI P, HUAN C, CHU Y, DING M, WANG Y, YAO Q, WANG P, QI G, WANG C. The Effects of High-volume Hemofiltration by Different Ultrasound Directing on Extra Vascular Lung Water Index in Patients with Septic Shock. IJPH. 47(9):1244-52.
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Original Article(s)