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首页> 外文期刊>Blood purification >Sequential hemoperfusion and continuous venovenous hemofiltration in treatment of severe tetramine poisoning.
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Sequential hemoperfusion and continuous venovenous hemofiltration in treatment of severe tetramine poisoning.

机译：顺序性血液灌流和连续静脉血液滤过治疗严重的四胺中毒。

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OBJECTIVE: It was the aim of this study to observe the effects of sequential hemoperfusion (HP) and continuous venovenous hemofiltration (CVVH) on patients with severe tetramine poisoning and to evaluate the ability of these modalities to remove tetramine. METHODS: Eighteen patients diagnosed as having severe tetramine poisoning were treated by blood purification, additional to routine medical therapy. Blood purification procedures included HP using activated charcoal for 3-5 h and consecutive CVVH for 24-36 h. Patients' clinical conditions, blood routine tests and serum chemical tests were evaluated every day after admission. Plasma tetramine concentrations were determined before and after HP. During CVVH, tetramine concentrations in plasma before and after passing through the filter and ultrafiltration at 2 and 12 h were also determined. RESULTS: Eight patients received blood purification within 12 h after onset of poisoning, and 10 patients received blood purification more than 12 h later. Early-treated patients showed a higher cure rate (100 vs. 60.0%; p < 0.05, chi(2) test) and shorter coma time than late-treated patients (26.0 +/- 23.2 h, range 5-70, vs. 59.7 +/- 27.7 h, range 20-96; p < 0.01, rank test). The mean plasma tetramine concentrations in early- and late-treated patients were comparable (0.095 +/- 0.036 vs. 0.134 +/- 0.110 mg/l; p > 0.05). Mean plasma tetramine concentration was reduced from 0.124 +/- 0.082 to 0.080 +/- 0.055 mg/l after HP. At 2 h of CVVH, mean plasma tetramine concentration was 0.078 +/- 0.064 mg/l, at 12 h of CVVH, 0.074 +/- 0.059 mg/l, and the ultrafiltration sieving coefficient at 2 and 12 h was 0.839 +/- 0.409 and 0.686 +/- 0.253 mg/l, respectively. CONCLUSION: Early sequential HP and CVVH therapy may significantly improve the outcome of patients with severe tetramine intoxication. HP can rapidly reduce the plasma concentration of tetramine, and CVVH can attenuate the plasma tetramine concentration rebound after HP by continuously removing tetramine from the plasma.
机译：目的：本研究的目的是观察顺序性血液灌流（HP）和连续静脉血液滤过（CVVH）对重症四胺中毒患者的影响，并评估这些方法清除四胺的能力。方法：除常规药物治疗外，还通过血液净化治疗了18名被诊断患有严重四胺中毒的患者。血液净化程序包括HP使用活性炭3-5小时和连续CVVH 24-36小时。入院后每天评估患者的临床状况，血液常规检查和血清化学检查。在HP之前和之后测定血浆四胺浓度。在CVVH期间，还确定了通过过滤器和在2和12 h超滤之前和之后血浆中的四胺浓度。结果：中毒发生后12小时内有8例患者接受了血液净化，超过12小时后有10例患者接受了血液净化。与后期治疗的患者相比，早期治疗的患者显示出更高的治愈率（100 vs. 60.0％; p <0.05，chi（2）测试）和更短的昏迷时间（26.0 +/- 23.2 h，范围为5-70vs。 59.7 +/- 27.7 h，范围20-96; p <0.01，等级测试）。早期和晚期治疗患者的血浆四胺浓度均相当（0.095 +/- 0.036与0.134 +/- 0.110 mg / l; p> 0.05）。 HP后平均血浆四胺浓度从0.124 +/- 0.082降低至0.080 +/- 0.055 mg / l。在CVVH 2小时时，血浆四胺的平均浓度为0.078 +/- 0.064 mg / l，在CVVH 12小时时为0.074 +/- 0.059 mg / l，在2和12小时的超滤筛分系数为0.839 +/-分别为0.409和0.686 +/- 0.253 mg / l。结论：早期序贯HP和CVVH治疗可能会显着改善严重四胺中毒患者的预后。 HP可以迅速降低血浆中的四胺浓度，而CVVH可以通过从血浆中连续去除四胺来减弱HP后血浆中的四胺浓度反弹。

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