Original Article
Effect of hemoperfusion combined with continuous veno-venous hemofiltration on acute paraquat poisoning: a Meta-analysis
Chao Lan, Qing Lyu, Hui Pei, Xing Meng, Qi Liu, Xinya Jia, Zhongshi Li, Chao Wang, Huaqing Ye, Yijun Fan
Published 2018-08-10
Cite as Chin Crit Care Med, 2018, 30(8): 783-789. DOI: 10.3760/cma.j.issn.2095-4352.2018.08.014
Abstract
ObjectiveTo comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP).
MethodsLiteratures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3.
ResultsTwenty-one studies were included with 2 222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1 246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77% (362/827) vs. 55.26% (604/1 093), odds ratio (OR) = 0.68, 95% confidential interval (95%CI) = 0.56-0.82, P = 0.000 1], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95%CI = 2.60-6.66, P < 0.000 01], incidence of MODS [25.93% (70/270) vs. 55.36% (155/280), OR = 0.26, 95%CI = 0.14-0.49, P < 0.000 1], and incidence of ARDS [30.37% (82/270) vs. 51.07% (143/280), OR = 0.42, 95%CI = 0.30-0.61, P < 0.000 01], and inefficiency rate [8.72% (13/149) vs. 34.64% (53/153), OR = 0.17, 95%CI = 0.09-0.34, P < 0.000 01] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies.
ConclusionHP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.
Key words:
Acute paraquat poisoning; Hemoperfusion; Continuous veno-venous hemofiltration; Hemopurification; Meta-analysis
Contributor Information
Chao Lan
Department of Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China
Qing Lyu
Hui Pei
Xing Meng
Qi Liu
Xinya Jia
Zhongshi Li
Chao Wang
Huaqing Ye
Yijun Fan
