SO SÁNH THAY ĐỔI LÂM SÀNG, CẬN LÂM SÀNG CỦA PHƯƠNG PHÁP CVVH VỚI CVVHDF Ở BỆNH NHÂN SỐC TRONG HỒI SỨC NGOẠI KHOA

Abstract

Objective: To compare the clinical indicators and laboratory values of CVVH (Continuous Veno - Venous Hemofiltration) method with CVVHDF (Continous Veno -Venous Hemodiafiltration) in shocked patients in surgical resuscitation. Methods: A randomized controlled trial study involved 30 surgically resuscitated patients getting continuous dialysis, divided into 2 groups of 15 patients each on using CVVH or CVVHDF. Differences in clinical and subclinical indicators as well as outcomes and recovery time of patients were recorded, coded and processed according to statistical methods. Results: Clinical indicators involving pulse rate, blood pressure, vasopressor dose (noradrenalin), mortality rate, duration in ICU, duration of mechanical ventilation were not statistically significant between the 2 groups. The mean number of filtrate per dialyzer, as well as the mean 24 hours filtrate count, were significantly lower in the CVVH group than in the CVVHDF group. For subclinical indicators: IL-6 decreased faster in the CVVH group than in CVVHDF, but the difference was not statistically significant. Lactate, Urea and creatinine decreased rapidly in both groups but decreased faster in the CVVHDF group however, there was no statistically significant difference between the 2 groups. SOFA score in the CVVHDF group decreased as soon as 24 h after dialysis commenced, while in the CVVH group SOFA score decreased significantly after 72 hours. Conclusion: In the CVVHDF group the kidney function improved earlier than in the CVVH group, but there was no statistically significant difference between the 2 study groups in terms of changes in clinical and subclinical indicators.