Continuous veno-venous hemofiltration for septic shock

Objective: To explore the efficacy of continuous veno-venous hemofiltration in the treatment of patients with septic shock. Methods: From January 2015 to January 2017, a total of 70 patients with sepsis admitted to the intensive care unit (ICU) of our hospital were recruited in the current study. The patients were randomly assigned to the conventional treatment group (control group) or the continuous veno-venous hemofiltration group (CVVH group). The patients in the control group were treated according to the International Guidelines for Management of Severe Sepsis and Septic Shock (2012) where as those in the CVVH group received hemofiltration with a polyflux 14 Shem of ilter (1.4 m(2) membrane area) in addition to all the above treatment given to the control group. The clinical outcomes including the cardiac, renal and hepatic functions, oxygen index (OI), vasopressor consumption and the serum lactic level were measured, the scores of the patients on the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sepsis-related Organ Failure Assessment (SOFA) were also assessed and the changes in the plasma concentrations of TNF-alpha, IL-6, IL-8, IL-10, HMGB1, vWF and E-selectins were also measured by the enzyme-linked immunosorbent assay (ELISA) before treatment and at 72 h after treatment, respectively. Results: Before treatment, the two groups did not differ significantly inthe cardiac, renal and hepatic functions, OI, vasopressor dosage, serum lactic level, APACHE II scoreand SOFA score and other inflammatory mediators. After treatment, among the patients in the CVVH group, improvements in cardiac, renal and hepatic functions and OI, a decrease in vasopressor dosage, a decline in serum lactic levels, significant reductions in APACHE II and SOFA scores, substantial reductions in the levels of TNF-alpha, IL-6, HMGB1, vWF and E-selectinsbut marked rise in IL-8 and IL-10 levels were noted (All P<0.05). Conclusion: Continuous veno-venous hemofiltration is effective in improving the clinical, physiological and biochemical outcomes of patients with septic shock.