Therapeutic Value of Blood Purification and Prognostic Utilities of Early Serum Procalcitonin, C Reactive Protein, and Brain Natriuretic Peptide Levels in Severely Burned Patients with Sepsis.

The objective of this study was to evaluate therapeutic effectiveness of blood purification (BP) in severely burned patients with sepsis and to assess the prognostic utilities of early serum levels of procalcitonin (PCT), C reactive protein (CRP), brain natriuretic peptide (BNP). One hundred and ninety-five burn sepsis patients admitted in our hospital during May, 2008-May, 2014 were selected for the study and randomly divided into BP treatment (n = 98) and the control groups (n = 97). All of these patients received conventional therapy, while the BP group underwent additional BP treatment. Therapeutic effectiveness and survival rates of the two groups were compared 28 days after the treatment. The BP group was further divided into survivor and mortality groups, and the early serum levels of PCT, CRP, and BNP were compared retrospectively to analyze their relationship with prognosis. Acute physiology and chronic health evaluation and sequential organ failure assessment scores in the two groups were not significantly different before the treatment (p > 0.05). However, after the treatment, mortality in BP group (19.39 %) was significantly lower (p < 0.05) than that of the controls (27.84 %). Serum levels of PCT and CRP in the survivor and mortality groups were not significantly different (p > 0.05), whereas the serum BNP was significantly lower in the patients who survived than those who died (p < 0.05). The receiver-operating characteristic curve analysis further showed that predictive value of PCT and CRP for the burn sepsis prognosis was low (p > 0.05), however, that of the BNP was good (p < 0.05). The results obtained in this study indicate that BP treatment at an early stage can significantly improve the prognosis of burn sepsis. Furthermore, BNP, an important mediator involved in myocardial infarction and heart failure was found to be positively related with the severity of sepsis suggesting its reliable utility as prognostic indicator of sepsis. Thus, serum BNP monitored during the treatment may assist in adjusting the therapeutic strategies.

RCT Entities:   Population Interventions Outcomes