Clinical Medicine
Expression of influence of continuous blood purification on the endothelin-1 and prognosis value in the neurogenic pulmonary edema
Hui Shi, Xueyan Bai, Jingzhang Li, Jun Ma, Bingxing Guan, Ruiping Chen
Published 2015-04-01
Cite as Chin J Emerg Med, 2015, 24(4): 427-430. DOI: 10.3760/cma.j.issn.1671-0282.2015.04.020
Abstract
ObjectiveTo explore the influnce on the endothelin-1 (ET-1) and clinical application value of continuous blood purification (CBP) on the treatment of severe craniocerebral injury with the neurogenic pulmonary edema (NPE) .
MethodsAll data about sixty patients with NPE were prospectively studied. These 60 patients were randomly (random number) divided into control group (n=30) and treatment group (n=30) . In control group, patients were rapidly given with lowering intracranial pressure, mechanical ventilation, calming, antibiotic therapy and so on. In the treatment group, patients received CBP integrated with routine treatment. On admission and 72 h posttreatment, ET-1, static lung compliance and oxygenation index were observed. Time of mechanical ventilation support, incidence rates of multipal organ dysfunction syndrome (MODS) were compared between two groups. The paired t-test was used for the amount data within the group. Chi-square was used for the constitute ratio and incidence ratio of the each relevant information. P <0.05 was considered statistically significant.
ResultsCompared to the control group, the level of ET-1 was decreased significantly in the treatment group [ (48±10) ng/L vs. (85± 14) ng/L]after 72 h post-treatment, while static lung compliance [ (60.9±2.3) mL/cmH2O vs. (31.4±4.8) mL/cmH2O]and oxygenation index [ (317±11) mmHg vs. (192±14) mmHg]increased significantly (P <0.05) . In treatment group and control group, the time of respirator intervention were[ (6.0±2.1) d vs. (11±3.2) d], and the statistical significance was shown (P <0.05) . Compared to the control group [56.7% (17/30) ], incidence rate of MODS [20.0% (6/30) ]was lower in treatment group (P <0.05) .
ConclusionsCBP combined with routine treatment, which can remove ET-1 effectively, improve oxygenation, reduce the time of mechanical ventilation support and incidence rate of MODS.
Key words:
Continuous blood purification; Neurogenic pulmonary edema; Craniocerebral injury; Endothelin-1; Continuous veno-venous hemofiltration; Multiple organ dysfunction syndrome; Treatment; Mechanical ventilation
Contributor Information
Hui Shi
Intensive Care Unit, Xingtai People Hospital, Hebei 054001, China
Xueyan Bai
Jingzhang Li
Jun Ma
Bingxing Guan
Ruiping Chen
