Clinical effects of hemoperfusion combined with pulse high-volume hemofiltration on septic shock.

Sepsis can cause septic shock, multiple organ dysfunction and even death. The combination of different blood purification would be the certain trend in the treatment of sepsis. This study was to evaluate the clinical effects of hemoperfusion (HP) combined with pulse high volume hemofiltration (PHVHF) on septic shock. Thirty cases were involved in this study and were randomly divided into two groups: HP and PHVHF group (n=15) and CVVH (continuous veno-venous hemofiltration) group (n=15). Acute physiology and chronic health evaluation (APACHE) II scores, sequential organ failure assessment (SOFA) scores as well as biochemical changes were measured before and after the treatment. The levels of IL-6, IL-10, and TNF-a in plasma were assessed by ELISA before and after treatment for 2 and 24h. The norepinephrine doses were also analyzed. The 28-day mortalities in both groups were also compared. In both groups, body temperature (BT), respiratory rate (RR), white blood cells (WBC), C-reactive protein (CRP), Procalcitonin (PCT), lactic acid, serum creatinine, APACHE II scores and SOFA scores decreased after hemofiltration (P<.05). The HP&PHVHF group was superior to the CVVH group in CRP, APACHE II score (P<.01), and heart rate (HR), WBC, PCT, SOFA (P<.05). The doses of norepinephrine were also decreased after treatment (P<.01), with more reduction in the HP&PHVHF group (P<.05). After 24h of treatment, the levels of IL-6, IL-10, and TNF-a decreased in both groups (P<.05), and the decrease was more significant in HP&PHVHF group (P<.05). In combined group, after 2h of hemoperfison, there was a significant reduction in these inflammatory factors (P<.01). Combined therapy group's mortality was 26.7%, while CVVH group's was 40%. HP combined with PHVHF has a significant effect on septic shock and can be an important therapy for septic shock.