Effect of Continuous Veno-Venous Hemodiafiltration Combined with Hem Perfusion on NLRP3 Levels and Prognosis in Children with Severe Sepsis

Abstract

Objectives: To explore the effect of continuous veno-venous hemodiafiltration (CVVHDF) + hemoperfusion (HP) on the level of nucleotide-binding oligomerization receptor protein 3 (NLRP3) and prognosis in children with severe sepsis.

Methods: This study is a prospective study. The research subjects are children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU) of the First Affiliated Hospital of Xinxiang Medical College from October 2021 to December 2023. The general information of the children, NLRP3 inflammasome levels in peripheral blood before and after treatment, Pediatric Sequential Organ Failure Assessment (pSOFA) score, incidence of sepsisassociated organ dysfunction (SAOD) during hospitalization, total hospital stays, PICU stay, and 28 Statistical analysis was performed on the prognosis of the day.

Results: Fifteen children underwent blood purification treatment (blood purification group) while another fifteen children underwent conventional treatment (conventional treatment group). After 72 hours, both groups showed a significant decrease in serum NLRP3 inflammasome levels (p<0.01), with the blood purification treatment group exhibiting a faster decline rate than the conventional treatment group. The pediatric sequential organ failure score (pSOFA) in the blood purification treatment group (CVVHDF+HP) decreased more than in the conventional treatment group. Additionally, the incidence of sepsis-associated organ dysfunction (SAOD) during hospitalization was lower in the blood purification treatment group compared to the conventional treatment group (p=0.039). Moreover, the hospitalization duration was significantly shorter in the blood purification treatment group than in the conventional treatment group (p<0.05).

Conclusion: Blood purification treatment (CVVHDF+HP) can reduce the early levels of NLRP3 in children with severe sepsis, reduce organ damage, and improve prognosis.