Pediatric Critical Illness

Clinical analysis of continuous blood purification in the treatment of neonatal septic shock with acute kidney injury

  • Jinglin XU ,
  • Hansong YANG ,
  • Xinhua CHEN ,
  • Jiangbin CHEN ,
  • Xiaoqing LI ,
  • Weifeng ZHANG ,
  • Dongmei CHEN
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  • 1. The Graduate School of Fujian Medical University, Fuzhou 35000, Fujian, China
    2. Teaching Hospital of Fujian Mcdical University, Quanzhou Children’s Hospital, Quanzhou 362000, Fujian, China

Received date: 2022-10-30

  Online published: 2023-06-12

Abstract

Objective To analyze the clinical indicators of continuous blood purification (CBP) in the treatment of neonatal septic shock with acute kidney injury (AKI). Methods The clinical data of neonates with septic shock and AKI treated with CBP in the neonatal intensive care unit from January 2015 to May 2022 were retrospectively analyzed. Results Fifteen neonates with septic shock and AKI were included in this study, and eight patients died with a mortality rate of 53.3%. Among them, 10 were boys and 5 were premature infants. The age of admission was 1.0 (1.0-6.0) days, the gestational age was 38.0 (34.0-41.0) weeks, the birth weight was 3100.0 (2850.0-3250.0) grams, and the AKI stage was 2 (2-3). All children needed mechanical ventilation and vasoactive drugs. The vasoactive inotropic score (VIS) was 110.0 (64.0-320.0). The mean arterial pressure (MAP) and urine output of the CBP treatment group at 24 hours and at the end of treatment were higher than that of the pre-treatment group, and the serum creatinine and urea nitrogen were lower than that of the pre-treatment group, the difference was statistically significant (P<0.05).The commonest CBP related adverse event was thrombocytopenia (45.5%). Univariate analysis showed that no risk factors for death related to CBP were found (P>0.05). Conclusions Bedside CBP can timely maintain hemodynamic stability in neonates with septic shock and AKI, correct shock, and significantly improve the renal function. It has good security.

Cite this article

Jinglin XU , Hansong YANG , Xinhua CHEN , Jiangbin CHEN , Xiaoqing LI , Weifeng ZHANG , Dongmei CHEN . Clinical analysis of continuous blood purification in the treatment of neonatal septic shock with acute kidney injury[J]. Journal of Clinical Pediatrics, 2023 , 41(6) : 436 -441 . DOI: 10.12372/jcp.2023.22e1459

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