Effect of extracorporeal membrane oxygenation combined with continuous renal replacement therapy on acute respiratory distress syndrome
Objective To evaluate the clinical effect of extracorporeal membrane oxygenation(ECMO)combined with continuous renal replacement therapy(CRRT)on patients with acute respiratory distress syndrome(ARDS).Methods Seventy-two ARDS patients admitted to Henan Provincial People's Hospital from June 2021 to June 2023 were selected as the research subjects.They were divided into a control group and a study group according to different treatment methods,with 36 cases in each group.The control group received routine treatment,while the study group received a combination of ECMO and CRRT in addition to the treatment in the control group.The basic data,oxygenation status(PaO2,PaCO2,oxygenation index,arterial lactate level),inflammatory indicators[leukocytes,procalcitonin(PCT),C-reactive protein(CRP)],acute physiological and chronic health score Ⅱ(APACHE Ⅱ score)and treatment-related indicators were compared between the two groups.Results Before treatment,there was no significant difference in PaO2,PaCO2,oxygenation index or lactate levels between the two groups(P＞0.05).After 3 days of treatment,PaO2 and oxygenation index significantly increased in both groups,while PaCO2 and arterial blood lactate levels significantly decreased;moreover,the above indicators in the study group showed more significant changes,and the differences were significant(P＜0.05).Before treatment,Before treatment,there was no significant difference in the levels of white blood cells,PCT or CRP between the two groups(P＞0.05).After 3 days of treatment,the levels of white blood cells,PCT,and CRP in both groups were significantly reduced,and those of the study group were lower than those of the control group,with significant differences(P＜0.05).Before treatment,there was no significant difference in APACHE Ⅱ scores between the two groups(P＞0.05).After 3 days of treatment,both groups showed a significant decrease in APACHE Ⅱ scores,and the study group showed a more significant decrease,with significant differences(P＜0.05).The mechanical ventilation time,ICU hospitalization time,and total hospitalization time of the study group were significantly shorter than those of the control group,and the differences were significant(P＜0.05).Conclusions ECMO combined with CRRT is effective on ARDS patients,which can improve oxygenation function,reduce inflammatory response,shorten the duration of mechanical ventilation,and reduce mortality,which is a safe and effective treatment strategy.
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