一项随机对照研究:高截止膜与高通量膜连续静脉-静脉血液滤过治疗脓毒性急性肾损伤的疗效和安全性

IF 2.2 3区 医学 Q3 ENGINEERING, BIOMEDICAL
Xiaowei Song, Caihong Liu, Min Zhang, Wei Wei, Letian Yang, Bo Wang, Yongxiu Huang, Guojiao Song, Fang Wang, Yingying Yang, Yuliang Zhao, Ling Zhang, Ping Fu
{"title":"一项随机对照研究:高截止膜与高通量膜连续静脉-静脉血液滤过治疗脓毒性急性肾损伤的疗效和安全性","authors":"Xiaowei Song, Caihong Liu, Min Zhang, Wei Wei, Letian Yang, Bo Wang, Yongxiu Huang, Guojiao Song, Fang Wang, Yingying Yang, Yuliang Zhao, Ling Zhang, Ping Fu","doi":"10.1111/aor.14963","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The application of high cutoff (HCO) membranes for continuous renal replacement therapy remains unclear in septic acute kidney injury (S-AKI) patients.</p><p><strong>Methods: </strong>S-AKI patients who received continuous veno-venous hemodiafiltration (CVVHDF) were randomly assigned to the experimental group (HCO membrane) and the control group (high flux membrane, HF membrane). Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum and waste fluid were measured at 0, 2, 12, and 24 h after CVVHDF initiation and the 28-day mortality.</p><p><strong>Results: </strong>Eleven patients were randomized to the HCO group, and 9 patients in the HF group, with a mean age of 54.9 ± 3.2 years and 6 patients (30%) being female. After 24 h of treatment with CVVHDF, there were significant reductions in serum IL-6 and TNF-α concentrations in the HCO group (p = 0.001, 0.015) and HF group (p = 0.004, 0.031). The serum IL-6 reduction rate of the HCO group was significantly higher than that of the HF group (79.21% vs. 42.69%, p = 0.025), while serum TNF-α reduction rates were comparable between the 2 groups. There were no significant changes in serum albumin after 24 h using either HCO membrane (28.7 ± 1.7 g/L vs. 32.7 ± 1.6 g/L, p = 0.138) or HF membrane (29.6 ± 1.1 g/L vs. 32.6 ± 1.3 g/L, p = 0.055). The two groups had similar 24-h filter clotting rates and 28-day mortality.</p><p><strong>Conclusion: </strong>While CVVHDF with the HCO membrane and HF membrane both achieved significant reductions in serum cytokine levels, the HCO membrane was associated with a greater reduction rate in IL-6 but not in TNF-α. No difference was observed in serum albumin, mortality, or filter clotting.</p><p><strong>Trial registration: </strong>Registry number: ChiCTR2000039725.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Efficacy and Safety of Continuous Veno-Venous Hemodiafiltration With High Cutoff Membrane Versus High Flux Membrane in Septic Acute Kidney Injury: A Randomized Controlled Study.\",\"authors\":\"Xiaowei Song, Caihong Liu, Min Zhang, Wei Wei, Letian Yang, Bo Wang, Yongxiu Huang, Guojiao Song, Fang Wang, Yingying Yang, Yuliang Zhao, Ling Zhang, Ping Fu\",\"doi\":\"10.1111/aor.14963\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The application of high cutoff (HCO) membranes for continuous renal replacement therapy remains unclear in septic acute kidney injury (S-AKI) patients.</p><p><strong>Methods: </strong>S-AKI patients who received continuous veno-venous hemodiafiltration (CVVHDF) were randomly assigned to the experimental group (HCO membrane) and the control group (high flux membrane, HF membrane). Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum and waste fluid were measured at 0, 2, 12, and 24 h after CVVHDF initiation and the 28-day mortality.</p><p><strong>Results: </strong>Eleven patients were randomized to the HCO group, and 9 patients in the HF group, with a mean age of 54.9 ± 3.2 years and 6 patients (30%) being female. After 24 h of treatment with CVVHDF, there were significant reductions in serum IL-6 and TNF-α concentrations in the HCO group (p = 0.001, 0.015) and HF group (p = 0.004, 0.031). The serum IL-6 reduction rate of the HCO group was significantly higher than that of the HF group (79.21% vs. 42.69%, p = 0.025), while serum TNF-α reduction rates were comparable between the 2 groups. There were no significant changes in serum albumin after 24 h using either HCO membrane (28.7 ± 1.7 g/L vs. 32.7 ± 1.6 g/L, p = 0.138) or HF membrane (29.6 ± 1.1 g/L vs. 32.6 ± 1.3 g/L, p = 0.055). The two groups had similar 24-h filter clotting rates and 28-day mortality.</p><p><strong>Conclusion: </strong>While CVVHDF with the HCO membrane and HF membrane both achieved significant reductions in serum cytokine levels, the HCO membrane was associated with a greater reduction rate in IL-6 but not in TNF-α. No difference was observed in serum albumin, mortality, or filter clotting.</p><p><strong>Trial registration: </strong>Registry number: ChiCTR2000039725.</p>\",\"PeriodicalId\":8450,\"journal\":{\"name\":\"Artificial organs\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Artificial organs\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/aor.14963\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Artificial organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/aor.14963","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0

摘要

背景:高截断膜(HCO)在脓毒性急性肾损伤(S-AKI)患者持续肾替代治疗中的应用尚不清楚。方法:将接受持续静脉-静脉血液滤过(CVVHDF)治疗的S-AKI患者随机分为实验组(HCO膜)和对照组(高通量膜、HF膜)。在CVVHDF启动后0、2、12、24 h及28 d死亡率时测定血清和废液中白细胞介素-6 (IL-6)和肿瘤坏死因子-α (TNF-α)的含量。结果:11例患者随机分为HCO组,9例患者随机分为HF组,平均年龄(54.9±3.2)岁,女性6例(30%)。CVVHDF治疗24 h后,HCO组(p = 0.001, 0.015)和HF组(p = 0.004, 0.031)血清IL-6和TNF-α浓度显著降低。HCO组血清IL-6降低率显著高于HF组(79.21% vs. 42.69%, p = 0.025),血清TNF-α降低率两组间具有可比性。使用HCO膜(28.7±1.7 g/L vs. 32.7±1.6 g/L, p = 0.138)和HF膜(29.6±1.1 g/L vs. 32.6±1.3 g/L, p = 0.055) 24 h后血清白蛋白无显著变化。两组24小时滤血凝血率和28天死亡率相似。结论:CVVHDF加HCO膜和HF膜均能显著降低血清细胞因子水平,但HCO膜对IL-6的降低率较大,对TNF-α的降低率较小。在血清白蛋白、死亡率或滤过物凝血方面没有观察到差异。试验注册:注册号:ChiCTR2000039725。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Efficacy and Safety of Continuous Veno-Venous Hemodiafiltration With High Cutoff Membrane Versus High Flux Membrane in Septic Acute Kidney Injury: A Randomized Controlled Study.

Background: The application of high cutoff (HCO) membranes for continuous renal replacement therapy remains unclear in septic acute kidney injury (S-AKI) patients.

Methods: S-AKI patients who received continuous veno-venous hemodiafiltration (CVVHDF) were randomly assigned to the experimental group (HCO membrane) and the control group (high flux membrane, HF membrane). Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum and waste fluid were measured at 0, 2, 12, and 24 h after CVVHDF initiation and the 28-day mortality.

Results: Eleven patients were randomized to the HCO group, and 9 patients in the HF group, with a mean age of 54.9 ± 3.2 years and 6 patients (30%) being female. After 24 h of treatment with CVVHDF, there were significant reductions in serum IL-6 and TNF-α concentrations in the HCO group (p = 0.001, 0.015) and HF group (p = 0.004, 0.031). The serum IL-6 reduction rate of the HCO group was significantly higher than that of the HF group (79.21% vs. 42.69%, p = 0.025), while serum TNF-α reduction rates were comparable between the 2 groups. There were no significant changes in serum albumin after 24 h using either HCO membrane (28.7 ± 1.7 g/L vs. 32.7 ± 1.6 g/L, p = 0.138) or HF membrane (29.6 ± 1.1 g/L vs. 32.6 ± 1.3 g/L, p = 0.055). The two groups had similar 24-h filter clotting rates and 28-day mortality.

Conclusion: While CVVHDF with the HCO membrane and HF membrane both achieved significant reductions in serum cytokine levels, the HCO membrane was associated with a greater reduction rate in IL-6 but not in TNF-α. No difference was observed in serum albumin, mortality, or filter clotting.

Trial registration: Registry number: ChiCTR2000039725.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Artificial organs
Artificial organs 工程技术-工程:生物医学
CiteScore
4.30
自引率
12.50%
发文量
303
审稿时长
4-8 weeks
期刊介绍: Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信