Chinese Journal of Evidence -Based Pediatric ›› 2017, Vol. 12 ›› Issue (5): 347-351.

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The application status of continuous blood purification in Chinese pediatric critical care medicine: a cross-sectional survey

YANG Xue1, QIAN Su-yun2, ZHU Yi-min3, XU Xuan4, LIU Chun-feng5, XU Feng6, REN Xiao-xu7,WANG Ying8, ZHANG Yu-cai9, LU Guo-ping1   

  • Received:2017-11-30 Revised:2017-11-30 Online:2017-10-25 Published:2017-10-25
  • Contact: LU Guo-ping

Abstract: AbstractObjective:To study the application of continuous blood purification(CBP) in Chinese pediatric critical care medicine from 2012 to 2016. Methods:A questionnaire named Application Status of Continuous Blood Purification Technology in 2012 was revised and perfected according to a crosssectional study. The Chinese Medical Association and Chinese Medical Doctor Association pediatric emergency or critical care unit members were selected as the investigation hospital. The survey contents: ① the nature, size and number of PICU beds of investigative hospitals; ②the implementation of peritoneal dialysis (IPD), hemodialysis (IHD), continuous renal replacement therapy (CRRT), plasma exchange (TPE), hemoperfusion (HP), blood adsorption (PA) and artificial liver support (ALSS); ③ the application in different diseases and the complications of CBP. Participated hospitals received a unified training and then finished filling out the questionnaire. Results:From December 30, 2016 to March 30, 2017, 53/55 hospitals in 39 cities of 28 provinces completed filing out the questionnaires, among which there were 39 pediatric hospital, 14 general hospitals and 49 Thirdlevel gradeA hospitals. All the 53 hospitals had PICU wards, and the average bed number of PICU was 25. 23 hospitals carried out CRRT, with 6 618 cases; 32 hospitals carried out TPE with 2 580 cases; 23 hospitals carried out HP with 2 238 cases; 20 hospitals carried out ALSS with 961 cases. The number of cases using various blood purification techniques showed an increasing trend year by year, while the proportion of IPD showed a downward trend.The implementation of CBP was mainly in ICU in more than 80% hospitals, followed by nephrology. CBP is mainly used in the treatment of sepsis (24.3%), MODS (20.3%), drug poisoning (12.7%) and other diseases.Neonatal CBP has been carried out in 9 hospitals, and 46 neonates received CBP treatment.1 093 children with liver failure were treated with CBP; the survival rates of each model were HP 85.7%, TPE+HP 72%, TPE 70.5%, CRRT 69.8%, TPE+CRRT 50%. The leading complication of CBP included deep vein catheter suction, membrane occlusion and so on.Conclusion:CBP is rapidly popularized in pediatric critical care in China from 2012 to 2016 and widely used in the treatment of sepsis.