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Continuous hemofiltration improves the prognosis of bacterial sepsis complicated by liver dysfunction in children

Yun Cui1,2, Xi Xiong1,2, Fei Wang1,2

  • 1Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China.

BMC Pediatrics
|August 13, 2018
PubMed

Insights

Continuous hemofiltration significantly reduces mortality in pediatric sepsis patients with liver dysfunction. This treatment lowers key biomarkers like total bilirubin and inflammatory cytokines, improving patient outcomes.

Area of Science:

  • Pediatric Critical Care Medicine
  • Sepsis Pathophysiology
  • Renal Replacement Therapy

Background:

  • Liver dysfunction is a critical factor impacting sepsis patient prognosis.
  • Bacterial sepsis with concurrent liver dysfunction presents a significant clinical challenge.

Purpose of the Study:

  • To assess the efficacy of continuous hemofiltration (CHF) in pediatric patients with bacterial sepsis and liver dysfunction.
  • To evaluate the impact of CHF on mortality and key biochemical markers.

Main Methods:

  • Retrospective analysis of 27 pediatric cases of bacterial sepsis with liver dysfunction.
  • Comparison between a continuous hemofiltration group (n=16) and a conventional management group (n=11).

Main Results:

  • Continuous hemofiltration significantly reduced 28-day mortality (31.3% vs. 72.7%) and pediatric intensive care unit (PICU) length of stay.
  • CHF initiation occurred at a median of 22.06 ± 17.68 hours post-PICU admission, with a median duration of 48 hours.
  • Significant decreases in total bilirubin, direct bilirubin, total bile acids, ammonia, lactate, TNF-α, and IL-6 were observed after 72 hours of CHF.

Conclusions:

  • Continuous hemofiltration is an effective intervention for pediatric bacterial sepsis with liver dysfunction.
  • CHF treatment is independently associated with improved 28-day mortality in this patient population.
  • CHF effectively reduces key indicators of liver injury and systemic inflammation.
Abstract

Keywords:
Bacterial sepsis with liver dysfunctionChildrenContinuous hemofiltrationMortality

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