The International journal of artificial organs
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Randomized Controlled Trial
Th17/regulatory T cell imbalance in sepsis patients with multiple organ dysfunction syndrome: attenuated by high-volume hemofiltration.
We assessed the Th17 (T-helper cell)/Treg (Regulatory T cell) imbalance in sepsis patients with multiple organ dysfunction syndrome (MODS) and the clinical benefits of continuous high-volume hemofiltration (HVHF). ⋯ The level of Th17/Treg imbalance in sepsis is related to the occurrence and prognosis of MODS. High-volume hemofiltration can attenuate the Th17/Treg imbalance in sepsis patients, possibly by removing inflammatory mediators.
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Randomized Controlled Trial
High cut-off hemofiltration versus standard hemofiltration: effect on plasma cytokines.
To study the effects of continuous veno-venous hemofiltration (CVVH) with high cut-off filters (CVVH-HCO) on plasma cytokine levels, sieving coefficient and clearance compared to CVVH using standard filters (CVVH-Std) in a nested cohort within a double-blind randomized controlled trial in severe acute kidney injury (AKI) patients. ⋯ CVVH-HCO achieved greater combined sieving coefficient and mass removal rate by ultrafiltration for a group of key cytokines than CVVH-Std. However, this effect did not differentially lower their plasma level over the first 72 hours. Our study does not support the use of CVVH-HCO to lower cytokines in critically ill patients with AKI.
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Randomized Controlled Trial
The effect of pulsatile cardiopulmonary bypass on lung function in elderly patients.
Cardiopulmonary bypass is still a major cause of lung injury and delay in pulmonary recovery after cardiac surgery. Although it has been shown that pulsatile flow induced by intra-aortic balloon pumping is beneficial for preserving lung function, it is not clear if the same beneficial effect can be accomplished with pulsatile flow generated in the extracorporeal circuit. Therefore, we investigated the effect of pulsatile flow, produced by a centrifugal pump, on lung function in elderly patients. ⋯ Pulsatile flow does not seem beneficial to postoperative lung function in elderly patients. Moreover, pulsatile flow does not affect lung function on a subclinical level as assessed by lung biomarkers.
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Randomized Controlled Trial
Peritoneal dialysis does not adversely affect kidney function recovery after congenital heart surgery.
Acute kidney injury (AKI) after cardiopulmonary bypass surgery to correct congenital heart disease is common. We prevent fluid overload and further cardiac compromise in oliguric infants with continuous peritoneal dialysis (CPD). The effect of CPD on kidney recovery is unknown, thus indications to discontinue CPD are unclear. We aimed to determine if CPD affects kidney recovery, measured by urine output and novel urinary AKI biomarker concentrations. ⋯ Our results suggest renal replacement therapy does not change the time course of kidney function recovery.
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Randomized Controlled Trial Comparative Study
Reduced sevoflurane loss during cardiopulmonary bypass when using a polymethylpentane versus a polypropylene oxygenator.
The goal of this investigation was to examine the influence of two oxygenators with different membranes, made of either polypropylene (PPL) or polymethylpentane (PMP), on the plasma concentration of sevoflurane during cardiopulmonary bypass. ⋯ The results of this study show that using a polymethylpentane membrane oxygenator rather than a polypropylene oxygenator significantly reduces the losses of sevoflurane, resulting in higher plasma concentrations and greater depth of anesthesia.