Öz
Giriş: Kanıtlar, sürekli renal replasman tedavisi (SRRT) ve hemodiyalizin Koronavirüs hastalığı-2019’un (COVID-19) tedavisinde etkili olabileceğini göstermektedir. Bu çalışma, SRRT ve hemodiyalizin COVID-19’lu hastalardaki komplikasyonlar, yaşamsal belirtiler ve laboratuvar parametreleri üzerindeki etkilerini karşılaştırmayı amaçlamıştır.
Gereç ve Yöntemler: Bu kesitsel çalışma, 2020-2021 yılları arasında Semnan şehrinin (İran) Kosar Hastanesi’nde hemoperfüzyon uygulanan 113 COVID-19’lu hasta üzerinde gerçekleştirildi. Hastalar, SRRT hemoperfüzyon grubu (n=49) ve hemodiyaliz grubu (n=64) olmak üzere iki gruba ayrıldı. Demografik değişkenler, altta yatan hastalık öyküsü, yaşamsal belirtiler, laboratuvar parametreleri, komplikasyonlar ve çeşitli sonlanımları içeren ve hastalarla veya refakatçilerle yapılan görüşmelerden ve tıbbi kayıtlardan elde edilen verilerin toplanmasında bir kontrol listesi kullanıldı. Veri analizi için IBM Statistical Package for the Social Sciences Statistics for Windows sürüm 26 kullanıldı.
Bulgular: Hemoperfüzyondan hastaneden taburcu olana kadar geçen süre (3,84±4,51 - 5,92±4,16 gün), entübasyon süresi (0,33±0,94 - 1,84±3,42), hemoperfüzyon sonrası ölüm (%64,06-26,5), durumsal istikrarsızlık (%21,9-8,2’ye) ve hemoperfüzyon sırasında ölüm (%14,1’e karşı %0); SRRT grubunda hemodiyaliz grubuna göre anlamlı derecede daha düşüktü (p<0,05). Tekrarlanan ölçümler varyans analizi (ANOVA) testinde, iki grup arasında farklı zamanlarda ölçülen laktat dehidrojenaz düzeyi, alkalen fosfataz düzeyi, beyaz küre sayısı ve C-reaktif protein düzeyi açısından istatistiksel olarak anlamlı bir fark vardı. SRRT grubunda hemoperfüzyondan sonra bu değişkenlerin ortalaması hemodiyaliz grubuna göre anlamlı derecede düşüktü (p<0,05).
Sonuç: SRRT hemoperfüzyon, hemoperfüzyon sırasında ve sonrasında hastanede kalış süresi, entübasyon süresi, durumsal instabilite ve mortalitenin hemodiyalizden daha az olması nedeniyle COVID-19’lu hastaların iyileşme sürecinde etkili olabilir.
Anahtar Kelimeler: Sürekli renal replasman tedavisi, SRRT, hemoperfüzyon, hemodiyaliz, COVID-19
Kaynakça
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