Effect of Pulsed Colloid Infusion Combined with Continuous Blood Purification for Treatment of Severe Capillary Leak Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 HaoDong , WangTao , LiZhi , QiZhijiang , NingFangyu , WangXiaozhi , LvChangjun

Department of Critical Care Medicine, Affiliated Hospital of Binzhou Medical College, Binzhou, Shandong, 256603, China;

Corresponding?author：

HaoDong, Email: sdbzzbh@163.com

Keywords：

Pulsed colloid infusion; Continuous blood purification; Capillary leak syndrome; Sepsis

DOI：

10.7507/1671-6205.2014014

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Objective To investigate the effect of pulsed colloid infusion combined with continuous blood purification (CBP) for treatment of severe capillary leak syndrome (CLS). Methods According to random principle,61 patients were divided into a control group(n=21),a CBP1 group(n=18) and a CBP2 group(n=22). All patients of three groups received routine treatment according to international guidelines 2008 for management of severe sepsis. The patients in the control group also received pulsed infusion colloid combined lasix. The patients in the CBP1 and CBP2 groups also received continuous veno-venous hemofiltration(CVVH) for 72 hours. The patients in the CBP1 group received concentrated colloid infusion combined lasix,and the patients in the CBP2 group received concentrated colloid infusion combined removing fluid. Blood gas analysis and Impedance Cardiography was performed before and 24,48 and 72 hours after therapy. The angiopoietin-2(Ang-2) was measured. Also the length of ICU stay,duration of mechanical ventilation,and death rate of patients in 28 days were observed. Results Compared with the control group and the CBP1 group,the length of ICU stay(days) and duration of mechanical ventilation (days) in the CBP2 group were significantly shorter(P<0.05),and the death rate in 28 days was lower(P<0.05). The patients in the CBP2 group showed more reduction in the APACHEⅡ score compared with the CBP1 group after therapy(P<0.05). The oxygenation index in the CBP2 group respectively increased at 24,48 and 72 hours after therapy(P<0.05). Compared with the control group and the CBP1 group,the oxygenation index in the CBP2 group respectively increased at the same time(P<0.05). The thoracic fluid content (TFC) in the CBP2 group respectively decreased at 24,48 and 72 hours(P<0.05) after therapy,and decreased compared with the control group and the CBP1 group at the same time(P<0.05). The serum levels of Ang-2 in the CBP2 group respectively decreased at 24,48 and 72 hours after therapy(P<0.05),and decreased compared with the control group and the CBP1 group at the same time(P<0.05). Conclusion Pulsed colloid infusion combined with continuous blood purification can reduce the severity of capillary leak and improves the outcome of patients with severe sepsis.

Citation： HaoDong, WangTao, LiZhi, QiZhijiang, NingFangyu, WangXiaozhi, LvChangjun. Effect of Pulsed Colloid Infusion Combined with Continuous Blood Purification for Treatment of Severe Capillary Leak Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(1): 58-62. doi: 10.7507/1671-6205.2014014 Copy

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6.	韓沙沙,孫婷,李志,等.連續性血液凈化治療對嚴重癥膿毒癥患者內皮細胞功能的影響.中國危重病急救醫學,2011,23:81-84.
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9.	Van der Heijden M,van Nieuw Ameron-gen GP,Chedamni S,et al.The angiopoietin-Tie2 system as a therapeutic target in sepsis and acute lung injury.Expert Opin Ther Targets,2009,13:39-53.
10.	Parikh SM,Mammoto T,Schultz A,et al.Excess circulating angiopoietin-2 may contribute to pulmonary vascular leak in sepsis in humans.PloS Med,2006,3:e46.
11.	Pchiule P,Chavez JC,LaManna JC.Hypoxic regulation of angiopoietin-2 expression in endothelial cells.J Biol Chem,2004,279:12171-12180.
12.	Van der Heijden M,van Nieuw Amerongen GP,Koolwijk P,et al.Angiopoietin-2,permeability edema,Occurrence and severity of ALI／ARDS in septic and non-septic critically ill patients.Thorax,2008,63:903-909.

1. Lee YS,Kim SY,Kwon CW,et al.Two cases of systemic capillary leak syndrome that were treated with pentastarch.Korean J Intern Med,2007,22:130-132.
2. 景炳文,林兆奮.關于毛細血管滲漏綜合征救治中有關問題的討論.中國危重病急救醫學,2009,21:705.
3. Chihara R,Nakamoto H,Arima H,et al.Systemic capillary leak syndrome.Intern Med,2002,41:953-956.
4. Chrysochoou G,Marcus RJ,Sureshkumar KK,et al.Renal replacement therapy in the critical Sale unit.Crit Care Nurs Q,2008,31:282-290.
5. 王錦權,陶曉根,張翠萍,等.連續性血液凈化對重癥膿毒癥患者內皮損傷保護作用.中華急診醫學雜志,2007,16:514-517.
6. 韓沙沙,孫婷,李志,等.連續性血液凈化治療對嚴重癥膿毒癥患者內皮細胞功能的影響.中國危重病急救醫學,2011,23:81-84.
7. Aird WC.Endothelium as a therapeutic target in sepsis.Curt Drug Targets,2007,8:501-507.
8. Aird WC.The role of the endothelium in severe sepsis and multiple organ dysfunction syndrome.Blood,2003,101:3765-3777.
9. Van der Heijden M,van Nieuw Ameron-gen GP,Chedamni S,et al.The angiopoietin-Tie2 system as a therapeutic target in sepsis and acute lung injury.Expert Opin Ther Targets,2009,13:39-53.
10. Parikh SM,Mammoto T,Schultz A,et al.Excess circulating angiopoietin-2 may contribute to pulmonary vascular leak in sepsis in humans.PloS Med,2006,3:e46.
11. Pchiule P,Chavez JC,LaManna JC.Hypoxic regulation of angiopoietin-2 expression in endothelial cells.J Biol Chem,2004,279:12171-12180.
12. Van der Heijden M,van Nieuw Amerongen GP,Koolwijk P,et al.Angiopoietin-2,permeability edema,Occurrence and severity of ALI／ARDS in septic and non-septic critically ill patients.Thorax,2008,63:903-909.

Chinese Journal of Respiratory and Critical Care Medicine

Effect of Pulsed Colloid Infusion Combined with Continuous Blood Purification for Treatment of Severe Capillary Leak Syndrome

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