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Continuous Blood purification on Influenza-Associated Neurological Disease in children: a retrospective cohort study
Jingwen Ni1, Kenan Fang1, Zhe Zhao2,3
1Pediatric intensive care unit, Luoyang Maternal and Child Health Hospital, Luoyang, China.
Insights
Continuous Blood Purification (CBP) significantly reduced IL-6 levels and improved survival rates in children with influenza-associated neurological disease. Further research is needed to confirm the link between IL-6 reduction and improved survival.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Influenza-associated neurological disease (IAND) lacks proven therapies.
- Continuous Blood Purification (CBP) was evaluated as a potential treatment for IAND in children.
- This study addresses the need for effective interventions in pediatric IAND.
Purpose of the Study:
- To evaluate the efficacy of Continuous Blood Purification (CBP) in treating children with influenza-associated neurological disease.
- To compare outcomes between children treated with CBP and those receiving standard intensive care.
- To assess the impact of CBP on inflammatory markers and mortality in pediatric IAND.
Main Methods:
- A retrospective cohort study was conducted in China from 2018-2020.
- 30 children (<18 years) with IAND were enrolled.
- Outcomes were compared between 18 children receiving CBP and 12 receiving maximal intensive care.
Main Results:
- CBP significantly decreased Interleukin-6 (IL-6) levels after 3 days (p=0.003).
- The 28-day mortality rate was significantly lower in the CBP group (11.11% vs. 50%, p=0.034).
- No significant differences were observed in other inflammatory markers (CRP, PCT) or baseline characteristics.
Conclusions:
- Continuous Blood Purification (CBP) demonstrates a significant reduction in IL-6 levels in pediatric IAND.
- CBP treatment was associated with improved survival rates in this cohort.
- The direct relationship between IL-6 reduction and survival benefit requires further investigation.
Background:
Due to lack of proven therapies, we evaluated the effect of CBP on Influenza-Associated Neurological Disease in children.
Methods:
A single-center, retrospective, cohort study was conducted in Luoyang, Henan province, China from January 2018 to January 2020. Children (<18 years) with influenza-associated neurological disease were enrolled in the study. Children with indications for CBP and parental consent received CBP (Continuous Blood purification), while others received maximal intensive care treatment because of the absence of parental consent. The outcomes of the CBP and non-CBP groups were compared. Categorical variables were presented as percentage and compared by Chi-square test. Continuous variables were expressed as median (interquartile ranges) and compared with non-parametric independent sample test. Statistical analyses were carried out by SPSS (version 26.0) and p < 0.05 (2 tailed) was considered to be statistically significant.
Results:
30 children with influenza-associated neurological disease were recruited to the study. 18 received CBP and the other 12 received maximal intensive care. There were no differences between CBP and non-CBP children in age, sex, body weight, type of influenza virus, neurological complications, Glasgow score, PIM-2 score and PCIS at admission (p > 0.05). The inflammatory factors (CRP, PCT and IL-6) of 30 cases were tested at admission and after 3 days of admission. In the CBP group, there was a significant decrease in IL-6 levels at 3 days of admission (p = 0.003) and a decrease in CRP and PCT levels, but no significant difference (p > 0.05). In the non-CBP group, there were no significant difference on levels of CRP, PCT and IL-6 at admission and 3-day of admission (p > 0.05). The 28-day mortality was significantly lower in the CBP group compared with the non-CBP group (11.11% vs. 50%, p = 0.034).
Conclusions:
CBP definitely reduces IL-6 levels significantly. We did find that the survival rate of patients in the CBP group was improved. But we don't know if there is a relationship between the reduction of IL-6 levels and the survival rate.
Trial Registration:
http://www.chictr.org.cn/index.aspx (ChiCTR2000031754).
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