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Chinese Journal of Blood Purification ›› 2006, Vol. 5 ›› Issue (1) : 33-37.

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Abstract

Objective To pool the data of randomized controlled trials (RCT) that compared continuous blood purification (CVVH) with non-CVVH or high volume hemofiltration (HVHF),and evaluate the efficacy of inflammatory mediators removal. Methods After search of the RCTs that studied the efficacy of CVVH or HVHF from MEDLINE and CBM discs, meta analysis was employed to evaluate the results of the RCTs. Results Nine RCTs comprising 204 cases were included, no significances were found in 12h, 24h, above 24h between CVVH and non-CVVH about removal on inflammatory mediators (TNF-α, IL-6), the weighted mean difference (WMD) and 95% confidence interval ( CI) were as follows: TNF-α：WMD12h ：-0.02（95％CI -0.07，0.03），P12h=0.46; WMD24h：-0.06（95％CI -0.31，0.19），P24h=0.64; WMD＞24h：-0.06（95％CI -0.14，0.01），P＞24h = 0.09；IL-6：WMD12h：3.01(95％CI -10.57，16.59)，P12h = 0.66; WMD24h：-1.26(95％CI -28.30，30.83)，P24h = 0.93; WMD＞24h ：-24.26 (95％CI -51.87，3.34)，P＞24h = 0.08。But between HVHF and CVVH, significant differences were found, to TNF-αthe WMD and 95% CI was -163.05(95% CI -227.53，-48.56)，P=0.005, and to IL-6, the WMD was -256.14(95% CI -392.68, -119.59)，P=0.0002. Conclusion The study showed that standard CVVH(=＜2L/h) was not able to eliminate inflammatory mediators effectively, HVHF(＞2L/h) significantly decreased the concentration of inflammatory mediators（TNF-α, IL-6）in plasma than standard CVVH.