AustralieFrV1, Main, Exploration, bibRecord, 00B849

A phase II randomized, controlled trial of continuous hemofiltration in sepsis

Identifieur interne : 00B849 ( Main/Exploration ); précédent : 00B848; suivant : 00B850

A phase II randomized, controlled trial of continuous hemofiltration in sepsis

Auteurs : Louise Cole [Australie] ; Rinaldo Bellomo [Australie] ; Graeme Hart ; Didier Journois [France] ; Piers Davenport [Australie] ; Peter Tipping [Australie] ; Claudio Ronco [Italie]

Source :

Critical care medicine [ 0090-3493 ] ; 2002.

RBID : Pascal:02-0130441

Descripteurs français

Pascal (Inist)
- Choc, Infection, Hémofiltration, Continu, Phase initiale, Essai clinique phase II, Randomisation, Insuffisance organique multiple, Inflammation, Facteur nécrose tumorale α, Interleukine, Complément, Traitement, Pronostic, Soin intensif, Adulte.
Wicri :
- topic : Adulte.

English descriptors

KwdEn :
- Adult, Complement, Continuous, Early phase, Hemofiltration, Infection, Inflammation, Intensive care, Interleukin, Multiple organ failure, Phase II trial, Prognosis, Randomization, Shock, Treatment, Tumor necrosis factor α.

Abstract

Objective: To study the effect of early and continuous venovenous hemofiltration (CWH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. Design: Randomized, controlled trial. Setting: Intensive care unit of a tertiary hospital. Patients: Twenty-four patients with early septic shock or septic organ dysfunction. Interventions: Random allocation to receive 48 hrs of iso-volemic CWH at 2 Uhr of fluid exchange or no hemofiltration. Measurements and Main Results: We measured the plasma concentrations of complement fractions C3a and C5a, interleukins 6, 8, and 10, and tumor necrosis factor α at baseline and 2, 24, 26, 48, and 72 hrs. A multiple organ dysfunction score (MODS) was calculated daily for each patient until death or discharge from the intensive care unit. The concentrations of most mediators decreased between baseline and 72 hrs. Some significant falls in concentration could be identified between specific time points, but CWH was not associated with an overall reduction in any plasma cytokine concentrations. There was also no difference between the mean cumulative MODS for control survivors (43.3 ± 19.7) and CWH survivors (33.2 ± 19.0; p =.30), and no difference between the average MODS calculated for all controls (4.1 ± 1.9) and all CWH subjects (3.3 ± 1.7; p =.26). CWH did not improve oxygenation, lower the platelet count, or reduce the duration of vasopressor support and mechanical ventilation. Conclusions: Early use of CWH at 2 Uhr did not reduce the circulating concentrations of several cytokines and anaphylatoxins associated with septic shock, or the organ dysfunction that followed severe sepsis. CWH using current technology cannot be recommended as an adjunct to the treatment of septic shock unless severe acute renal failure is present.

Affiliations:

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Le document en format XML

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<author><name sortKey="Cole, Louise" sort="Cole, Louise" uniqKey="Cole L" first="Louise" last="Cole">Louise Cole</name>
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<author><name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name>
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<author><name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name>
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<author><name sortKey="Tipping, Peter" sort="Tipping, Peter" uniqKey="Tipping P" first="Peter" last="Tipping">Peter Tipping</name>
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<series><title level="j" type="main">Critical care medicine</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Complement</term>
<term>Continuous</term>
<term>Early phase</term>
<term>Hemofiltration</term>
<term>Infection</term>
<term>Inflammation</term>
<term>Intensive care</term>
<term>Interleukin</term>
<term>Multiple organ failure</term>
<term>Phase II trial</term>
<term>Prognosis</term>
<term>Randomization</term>
<term>Shock</term>
<term>Treatment</term>
<term>Tumor necrosis factor α</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Choc</term>
<term>Infection</term>
<term>Hémofiltration</term>
<term>Continu</term>
<term>Phase initiale</term>
<term>Essai clinique phase II</term>
<term>Randomisation</term>
<term>Insuffisance organique multiple</term>
<term>Inflammation</term>
<term>Facteur nécrose tumorale α</term>
<term>Interleukine</term>
<term>Complément</term>
<term>Traitement</term>
<term>Pronostic</term>
<term>Soin intensif</term>
<term>Adulte</term>
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<front><div type="abstract" xml:lang="en">Objective: To study the effect of early and continuous venovenous hemofiltration (CWH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. Design: Randomized, controlled trial. Setting: Intensive care unit of a tertiary hospital. Patients: Twenty-four patients with early septic shock or septic organ dysfunction. Interventions: Random allocation to receive 48 hrs of iso-volemic CWH at 2 Uhr of fluid exchange or no hemofiltration. Measurements and Main Results: We measured the plasma concentrations of complement fractions C3a and C5a, interleukins 6, 8, and 10, and tumor necrosis factor α at baseline and 2, 24, 26, 48, and 72 hrs. A multiple organ dysfunction score (MODS) was calculated daily for each patient until death or discharge from the intensive care unit. The concentrations of most mediators decreased between baseline and 72 hrs. Some significant falls in concentration could be identified between specific time points, but CWH was not associated with an overall reduction in any plasma cytokine concentrations. There was also no difference between the mean cumulative MODS for control survivors (43.3 ± 19.7) and CWH survivors (33.2 ± 19.0; p =.30), and no difference between the average MODS calculated for all controls (4.1 ± 1.9) and all CWH subjects (3.3 ± 1.7; p =.26). CWH did not improve oxygenation, lower the platelet count, or reduce the duration of vasopressor support and mechanical ventilation. Conclusions: Early use of CWH at 2 Uhr did not reduce the circulating concentrations of several cytokines and anaphylatoxins associated with septic shock, or the organ dysfunction that followed severe sepsis. CWH using current technology cannot be recommended as an adjunct to the treatment of septic shock unless severe acute renal failure is present.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>France</li>
<li>Italie</li>
</country>
<region><li>Victoria (État)</li>
<li>Île-de-France</li>
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<settlement><li>Melbourne</li>
<li>Paris</li>
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<tree><noCountry><name sortKey="Hart, Graeme" sort="Hart, Graeme" uniqKey="Hart G" first="Graeme" last="Hart">Graeme Hart</name>
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<country name="Australie"><region name="Victoria (État)"><name sortKey="Cole, Louise" sort="Cole, Louise" uniqKey="Cole L" first="Louise" last="Cole">Louise Cole</name>
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<name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name>
<name sortKey="Davenport, Piers" sort="Davenport, Piers" uniqKey="Davenport P" first="Piers" last="Davenport">Piers Davenport</name>
<name sortKey="Tipping, Peter" sort="Tipping, Peter" uniqKey="Tipping P" first="Peter" last="Tipping">Peter Tipping</name>
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<country name="France"><region name="Île-de-France"><name sortKey="Journois, Didier" sort="Journois, Didier" uniqKey="Journois D" first="Didier" last="Journois">Didier Journois</name>
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<country name="Italie"><noRegion><name sortKey="Ronco, Claudio" sort="Ronco, Claudio" uniqKey="Ronco C" first="Claudio" last="Ronco">Claudio Ronco</name>
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</record>

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A phase II randomized, controlled trial of continuous hemofiltration in sepsis

A phase II randomized, controlled trial of continuous hemofiltration in sepsis

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri