周树生血浆置换在重症患者中的应用周树生 .pptVIP

Ann Thorac Surg.2004 May;77(5):1839-41 血浆置换有效治疗甲状腺风暴 第IV类：对照的临床研究证实PE无效。如肾移植排斥反应等。 美国血液分离学会（American Society for Aphesis）将血浆置换的 疗效分为四类： 血浆置换在重症患者临床中的应用 目前的研究认为：PE能更有效清除血浆中与蛋白质结合的毒素，如内毒素和免疫复合 物等中大分子物质，改善生理参数，降低死亡率。 血浆置换在脓毒血症和多脏器功能障碍综合症的应用 Plasma concentrations of endotoxin significantly decreased (p .001). Serum concentrations of TNF-a significantly decreased (p .05). Serum concentrations of IL-6 decreased significantly (p .05). Crit Care Med. 1998 May;26(5):873-6 PE-sepsis and septic:PE能有效清除炎症介质 BMC Anesthesiol.2014 Apr 7;14(1):24 去甲肾上腺素剂量 before,during and after first therapeutic TPE in non-survivors and survivors Therapeutic?plasma?exchange?as?rescue?therapy?in?severe?sepsis?and?septic?shock:? retrospective?observational single-centre?study?of?23?patients TPE as rescue therapy in 23 patients with severe sepsis or septic shock from 2005 to 2012 BMC Anesthesiol. 2014 Apr 7;14(1):24 Therapeutic?plasma?exchange?as?rescue?therapy?in?severe?sepsis?and?septic?shock:? retrospective?observational single-centre?study?of?23?patients TPE as rescue therapy in 23 patients with severe sepsis or septic shock from 2005 to 2012 Net fluid balances as surrogate marker of septic vascular permeability are presented relating to the time of first TPE BMC Anesthesiol. 2014 Apr 7;14(1):24 Therapeutic?plasma?exchange?as?rescue?therapy?in?severe?sepsis?and?septic?shock:? retrospective?observational single-centre?study?of?23?patients TPE as rescue therapy in 23 patients with severe sepsis or septic shock from 2005 to 2012 PE may be an important adjuvant（辅助） to conventional treatment to reduce mortality in patients with severe sepsis or septic shock Intensive Care Med. 2002 Oct;28(10):1434-9 Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial PE组 对照组 Plasma exchange as rescue therapy in multiple organ failure 76 patients (41 male and 35 female) with DIC and MODS (including ARF) 回顾性对照研究，器官衰竭评分5，（range 1~6） 预计存活率为20% Plasma exchange was p