Effects Of Hvhf Therapy On Serum Inflammatory Factors, Pulmonary Function, And Hemodynamic Indexes Of Patients With Sepsis Complicated By Acute Respiratory Distress Syndrome

Objective: The goal of this study was to observe the effects of continuous high-volume hemofiltration (HVHF) therapy on serum inflammatory factors, pulmonary function, and hemodynamic indexes of patients with sepsis complicated by acute respiratory distress syndrome (ARDS). Methods: A total of 82 patients with sepsis complicated by ARDS were equally divided into the HVHF group and the control group. Patients in the control group were given anti-infection treatment and primary affection while patients in the HVHF group received continuous HVHF treatment additionally based on treatment in the control group. At three days after treatment, the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and procalcitonin (PCT) in the serum of patients in the two groups were detected. At the same time, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and the ratio of fraction of inspired oxygen (FiO(2)) to PaO2 between the two groups were compared, and heart rate (HR), mean arterial pressure (MAP), pulmonary artery wedge pressure (PAWP) and cardiac index (CI) were monitored. Results: The detection results at three days after treatment showed that the levels of TNF-alpha, IL-6, and PCT in serum of patients in the control and HVHF groups were (25.68 +/- 8.86 vs. 15.55 +/- 3.98) (89.68 +/- 31.44 vs. 65.32 +/- 45.01) ng.L-1 and (7.77 +/- 1.01 vs. 5.04 +/- 0.89) ng.L-1, respectively, demonstrating that inflammatory factors in both groups declined and changes in the HVHF group were more obvious than those in the control group (P<0.05). Moreover, the hemodynamic indexes and pulmonary function in the two groups were improved to some extent. However, the levels in the HVHF group were more remarkably increased compared to those in the control group, in which PaO2, FiO(2)/PO2, PAWP and CI were significantly different (P<0.05). In addition, clinical monitoring indexes [white blood cell count and Acute Physiology and Chronic Health Evaluation II (APACHE II)] in the HVHF group were more significantly improved than those in the control group, and the mortality rate acquired in follow-up investigation was lower than that in the control group. Conclusion: Therefore, continuous HVHF treatment is very helpful in the protection of main organ functions and for recovery of pulmonary function. It can enhance survival rate as it can strengthen the scavenging capacity of inflammatory factors in the blood circulation, and has efficacy in improving hemodynamics and tissue oxygenation, as well as maintaining a steady internal environment. Therefore, continuous HVHF therapy can provide an effective reference value for clinical practice and applications.