Abstract | BACKGROUND: METHODS: An observational prospective multicenter cohort study was conducted in four mixed medical-surgical ICUs. Thirty-eight patients with septic shock and AKI (KDIGO stage≥1) treated with HCO- CVVHD have been included in this study. Patients were divided into Survivors and non-Survivors according to mortality observed at 72nd hr of treatment. The variation of SOFA scores and clinical/biochemical parameters were described over time for the entire population and specifically for Survivors and non-Survivors. Similarly, circulating inflammatory mediators (as IL-6, TNF-a and IL-10) were described over time. A logistic regression analysis was used to identify the baseline clinical and biochemical parameters associated with 72 hrs-ICU mortality. RESULTS: Overall, the mean SOFA score was 12±3 at baseline, 10.9±3 at 6hrs, 9.8±3 at 12hrs, 8.9±3.3 at 24 hrs, and 8±3.5 at 48 hrs after HCO- CVVHD initiation; and 6.5±2.7 at 24 hrs and 6.6±3 at 48 hrs after HCO- CVVHD discontinuation. In the multivariate regression analysis, baseline serum lactate levels and AKI stage independently correlated with short-term mortality during HCO- CVVHD. A significant reduction was observed in circulating levels of TNFα and IL-6 among Survivors. CONCLUSIONS: SOFA score significantly decreased early after initiation of HCO- CVVHD in patients with septic AKI. Baseline lactate levels and the AKI stage resulted to be associated to 72 hrs-ICU-mortality.
|
Authors | Gianluca Villa, Cosimo Chelazzi, Elena Morettini, Lucia Zamidei, Serafina Valente, A Lucia Caldini, Giovanni Zagli, A Raffaele De Gaudio, Stefano Romagnoli |
Journal | PloS one
(PLoS One)
Vol. 12
Issue 2
Pg. e0172039
( 2017)
ISSN: 1932-6203 [Electronic] United States |
PMID | 28207795
(Publication Type: Journal Article, Multicenter Study, Observational Study)
|
Topics |
- Acute Kidney Injury
(complications, therapy)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Female
- Hemofiltration
(adverse effects)
- Humans
- Intensive Care Units
- Male
- Middle Aged
- Multiple Organ Failure
(etiology)
- Prospective Studies
- Renal Dialysis
(adverse effects)
- Shock, Septic
(complications, therapy)
- Young Adult
|