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Results of treatment of patients with multiple organ failure supported by pre and post dilution continuous renal replacement therapy

Objectives: To evaluate the outcome of the patients with multiple organ failure (MOF) supported by pre-and-post-dilution continuous renal replacement therapy (CRRT) and compare some factors related to the results, progression and prognosis of the patients supported by preand-post-dilution to those by post-dilution only. | Journal of military pharmaco-medicine no2-2018 RESULTS OF TREATMENT OF PATIENTS WITH MULTIPLE ORGAN FAILURE SUPPORTED BY PRE-AND POST-DILUTION CONTINUOUS RENAL REPLACEMENT THERAPY Huynh Thi Ngoc Thuy*; Hoang Trung Vinh**; Do Quoc Huy* SUMMARY Objectives: To evaluate the outcome of the patients with multiple organ failure (MOF) supported by pre-and-post-dilution continuous renal replacement therapy (CRRT) and compare some factors related to the results, progression and prognosis of the patients supported by preand-post-dilution to those by post-dilution only. Subjects and methods: Prospective trial, compared before and after intervention in 77 patients diagnosed of MOF according to SOFA score, including 2 groups: 41 patients in group 1 (study group) (supported by pre-and-postdilution), 36 patients in group 2 (control group) (supported by post-dilution). Data were received from clinical examination, diagnostic tests during treatment. Results: Comparing with postdilution, patients in group of pre-and-post-dilution had lower serum creatinine at the end of study (1.6 ± 0.9 mg/dL versus 2.3 ± 1.5 mg/dL), higher TNF-α clearance (16.8 pg/mL versus 4.0 pg/mL), filter lifetime was longer (31.9 ± 10.8 h versus 26.7 ± 10.6 h), the percentage of patients with acute kidney injury (AKI) as well as failure of ≥ 5 were lower at the end of the study (36.6% vs 72.2% and 24.4% vs 50%). The mortality rates of the two groups were similar (70.7% and 72.2%). Conclusion: Pre-and-post-dilution has many advantages in improving kidney function, purifying cytokines and prolonging the filter lifetime. * Keywords: Multiple organ failure; Continuous renal replacement therapy; Post-dilution; Preand-post-dilution. INTRODUCTION Multiple organ failure is the disease with severely progression and makes many patients stayed at intensive care unit (ICU) for a long time. Although therapeutic progresses, the mortality rates remained the highest in ICU. So that, besides of the intensive treatment .