Abstract Objective To assess the outcome of patients with cancer-related sepsis requiring continuous renal replacement therapy (CRRT) in a single-center pediatric intensive care unit (PICU). Method Children with sepsis who necessitate CRRT from January 2017 to December 2021 were enrolled. The patients with leukemia/lymphoma or solid tumors were defined as underlying cancer. Multivariate logistic regression analysis was performed to identify the death risk factors in patients with cancer-related sepsis. Results A total of 146 patients were qualified for inclusion. Forty-six (31.5%) patients with cancer-related sepsis and 100 (68.5%) non-cancer-related sepsis. The overall PICU mortality was 28.1% (41/146), and mortality was significantly higher in cancer-related sepsis patients compared with non-cancer patients (41.3% vs. 22.0%, p = 0.016). Need mechanical ventilation, p-SOFA, acute liver failure, higher fluid overload at CRRT initiation, hypoalbuminemia, and high inotropic support were associated with PICU mortality in cancer-related sepsis patients. Moreover, levels of IL-6, total bilirubin, creatinine, blood urea nitrogen, and international normalized ratio were significantly higher in non-survivors than survivors. In multivariate logistic regression analysis, pediatric sequential organ failure assessment (p-SOFA) score (OR:1.805 [95%CI: 1.047-3.113]) and serum albumin level (OR: 0.758 [95%CI: 0.581 -0.988]) were death risk factors in cancer-related sepsis receiving CRRT, and the AUC of combined index of p-SOFA and albumin was 0.852 (95% CI: 0.730-0.974). Conclusion The overall PICU mortality is high in cancer-related sepsis necessitating CRRT. Higher p-SOFA and lower albumin were independent risk factors for PICU mortality. cancerrelated cancer related (CRRT singlecenter single center PICU. . (PICU) 201 202 enrolled leukemialymphoma leukemia lymphoma 14 inclusion Fortysix Forty six 31.5% 315 31 5 (31.5% 10 68.5% 685 68 (68.5% noncancerrelated non 281 28 1 28.1 41/146, 41146 41/146 , 41 (41/146) noncancer 41.3% 413 3 (41.3 vs 220 22 0 22.0% 0.016. 0016 0.016 016 0.016) ventilation pSOFA, pSOFA SOFA, SOFA initiation hypoalbuminemia Moreover IL6, IL6 IL 6, 6 IL-6 bilirubin creatinine nitrogen nonsurvivors survivors (p-SOFA OR1.805 OR1805 OR 1.805 805 (OR:1.80 95%CI 95CI CI 95 [95%CI 1.0473.113 10473113 1.047 3.113 047 113 1.047-3.113] (OR 0758 758 0.75 0581 581 0.58 0.988 0988 988 -0.988] 0852 852 0.85 95% (95 0.7300.974. 07300974 0.730 0.974 730 974 0.730-0.974) (PICU 20 31.5 (31.5 68.5 (68.5 2 28. 4114 41/14 4 (41/146 41.3 (41. 22.0 001 0.01 01 IL- OR1 OR1.80 OR180 1805 1.80 80 (OR:1.8 9 0473 1.0473.11 1047311 1047 1.04 3113 3.11 04 11 1.047-3.113 075 75 0.7 058 58 0.5 0.98 098 98 -0.988 085 85 0.8 (9 7300 0.7300.974 0730097 0730 0.73 0974 0.97 73 97 0.730-0.974 31. (31. 68. (68. 411 41/1 (41/14 41. (41 22. 00 0.0 OR1.8 OR18 180 1.8 8 (OR:1. 1.0473.1 104731 104 1.0 311 3.1 1.047-3.11 07 7 0. 05 0.9 09 -0.98 08 ( 0.7300.97 073009 073 097 0.730-0.97 (31 (68 41/ (41/1 (4 OR1. 18 1. (OR:1 1.0473. 10473 3. 1.047-3.1 -0.9 0.7300.9 07300 0.730-0.9 (3 (6 (41/ 1.0473 1.047-3. -0. 0.7300. 0.730-0. 1.047-3 -0 0.7300 0.730-0 1.047- - 0.730-

Abstract Purpose: To investigate efficacy of combined use of parecoxib and dexmedetomidine on postoperative pain and early cognitive dysfunction after laparoscopic cholecystectomy for elderly patients. Methods: The present prospective randomized controlled study included a total of 80 patients who underwent laparoscopic cholecystectomy surgery during January 2016 to November 2017 in our hospital. All patients were randomly divided into 4 groups, the parecoxib group, the dexmedetomidine group, the parecoxib and dexmedetomidine combined group, and the control group. Demographic data and clinical data were collected. Indexes of heart rate (HR), mean arterial pressure (MAP), levels of jugular venous oxygen saturation (SjvO2) and jugular venous oxygen pressure (PjvO2) were recorded at different time points before and during the surgery. The mini-mental state examination (MMSE) score, Ramsay score and Visual Analogue Score (VAS) were measured. Results: Levels of both SjvO2 and PjvO2 were significantly higher in parecoxib group, dexmedetomidine group and the combined group than the control group. Meanwhile, levels of both SjvO2 and PjvO2 in the combined group were the highest. VAS scores were significantly lower in the combined group than all other groups, and total patient controlled intravenous analgesia (PCIA) pressing times within 48 h after surgery were the lowest in the combined group. Both Ramsay and MMSE scores were the highest in the combined group compared with other groups, while were the lowest in the control group. Conclusion: The combined use of parecoxib and dexmedetomidine could reduce the postoperative pain and improve the postoperative sedation and cognitive conditions of patients after laparoscopic cholecystectomy.