Objective: The objective of this study is to assess and compare the efficacy of oXiris with conventional continuous renal replacement therapy (CRRT) in managing severe abdominal infections. Methods: A retrospective analysis encompassing cases from 2017 to 2023 was conducted at the Department of Critical Care Medicine within the First Affiliated Hospital of Fujian Medical University. Parameters including heart rate (HR), mean arterial pressure (MAP), oxygenation index, lactate (Lac), platelet count, neutrophil ratio, procalcitonin, C-reactive protein (CRP), interleukin 6 (IL-6), norepinephrine dosage, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) were recorded prior to treatment initiation, at 24 h, and 72 h after treatment for both the oXiris and conventional CRRT groups. In addition, the duration of respiratory support, CRRT treatment, length of stay in the intensive care unit (ICU), total hospitalization period, and mortality rates at 14 and 28 days for both groups were recorded. Results: 1) Within the conventional CRRT group, notable enhancement was observed solely in Lac levels at 24 h after treatment compared with pretreatment levels. In addition, at 72 h after treatment, improvements were evident in HR, Lac, CRP, and IL-6 levels. 2) Conversely, the oXiris group exhibited improvements in HR, MAP, Lac, oxygenation index, neutrophil ratio, and IL-6 at 24 h after treatment when compared with baseline values. In addition, reductions were observed in APACHE II and SOFA scores. At 72 h after treatment, all parameters demonstrated enhancement except for platelet count. 3) Analysis of the changes in the indexes (Δ) between the two groups at 24 h after treatment revealed variances in HR, MAP, Lac, norepinephrine dosage, CRP levels, IL-6 levels, APACHE II scores, and SOFA scores. 4) The Δ indexes at 72 h after treatment indicated more significant improvements following oXiris treatment for both groups, except for procalcitonin. 5) The 14-day mortality rate (24.4%) exhibited a significant reduction in the oXiris group when compared with the conventional group (43.6%). However, no significant difference was observed in the 28-day mortality rate between the two groups. 6) Subsequent to multifactorial logistic regression analysis, the results indicated that oXiris treatment correlated with a noteworthy decrease in the 14-day and 28-day mortality rates associated with severe abdominal infections, by 71.3% and 67.6%, respectively. Conclusion: oXiris demonstrates clear advantages over conventional CRRT in the management of severe abdominal infections. Notably, it reduces the fatality rates, thereby establishing itself as a promising and potent therapeutic option.
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http://dx.doi.org/10.1097/SHK.0000000000002437 | DOI Listing |
J West Afr Coll Surg
July 2024
Department of Surgery, Faculty of Clinical Sciences, Usmanu Danfodiyo University, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Background: Necrotizing fasciitis (NF) is a severe soft tissue infection typified by swiftly spreading necrosis of the fascia and subcutaneous fat with successive necrosis of the skin which affects all age groups.
Objective: To compare the clinical presentation and treatment outcome of NF between children and adults.
Materials And Methods: A prospective descriptive study of all patients presenting with NF to the (Usmanu Danfodiyo Univrersity Teaching Hospital, Sokoto), from September 2018 to August 2019.
Cureus
November 2024
Urology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
The initial six months following HIV infection have a high viral load. Nonspecific presentations might lead to the missing primary HIV diagnosis. Multiorgan and multisystem diagnosis is a rare presentation of primary HIV.
View Article and Find Full Text PDFCureus
November 2024
Radiology, Second Health Cluster, Jeddah, SAU.
Pulmonary embolism (PE) is a potentially fatal condition with variable clinical presentations, ranging from classic respiratory symptoms to rare atypical manifestations. This report describes a 47-year-old woman who presented with acute, severe right upper quadrant abdominal pain, nausea, and vomiting without respiratory complaints. Initial investigations, including abdominal ultrasound and contrast-enhanced CT of the abdomen, revealed no intra-abdominal abnormalities.
View Article and Find Full Text PDFCureus
November 2024
Hematology and Medical Oncology, Kettering Health, Kettering, USA.
Rosai-Dorfman disease (RDD) is a rare proliferative histiocytic disorder characterized by sinus histiocytosis with massive lymphadenopathy, rarely presenting with severe and life-threatening extra-nodal features. The rarity of RDD, clinically variant phenotype, limited data, and lack of a current standardized management approach make treatment decisions difficult. Herein, we present a case of life-threatening, disseminated RDD with rare clinical features of recurrent pericardial effusion, bilateral pleural effusions, and abdominal tissue fibrosis successfully treated with six cycles of cladribine, achieving clinical remission.
View Article and Find Full Text PDFFront Surg
December 2024
Department of Radiology, Shaoxing Second Hospital, Shaoxing, Zhejiang, China.
Introduction: Retroperitoneal hematoma with ongoing hemorrhage is a rare but critical condition following blunt abdominal trauma, requiring urgent evaluation and management. This case details a large retroperitoneal hematoma in the right iliac fossa caused by a rupture of the deep circumflex iliac artery (DCIA), successfully treated with transcatheter arterial embolization.
Case Description: A 66-year-old female presented to our hospital six hours after an electric tricycle accident with dizziness, fatigue, hypotension (80/50 mmHg), and tachycardia (105 beats/min).
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