Effect of continuous renal replacement treatment on stress reaction in patients with severe trauma

OBJECTIVE: To investigate the effect of continuous renal replacement treatment (CRRT) stresses reaction in patients with severe trauma and its clinical significance. METHODS: Twenty-nine patients with severe trauma were randomly divided into two groups: treatment group (15 cases, treated with continuous veno-venous hemofiltration (CVVH) within 12 hours after trauma) and control group (14 cases, not treated with CVVH). The levels of cortical, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in plasma were determined at 12 hours, 24 hours, 48 hours, 72 hours after trauma, and the temperature, heart beat, respiratory rate, blood pressure were observed. RESULTS: The levels of cortical, IL-6 in both groups increased to some degree in 12 hours. In control group, the level of cortical increased gradually, peaking at 48 hours, and it was still higher than normal at 72 hours. The level of cortical decreased in the treatment group gradually after 24 hours, approaching normal level at 72 hours. When compared with the control group, the levels of cortical in plasma were lower obviously in the treatment group at 24 hours, 48 hours, 72 hours (all P<0.001). The level of IL-6 decreased obviously after 12 hours and was lower evidently at 24 hours,48 hours, 72 hours (all P<0.05). The clinic symptoms were improved obviously. The level of TNF-alpha was increased at each time point in both groups, but there was no significant difference between two groups. CONCLUSION: CRRT can eliminate effectively the stress hormone, and reduce stress reaction obviously. The change in IL-6 is more marked than that of cortical.