Study of variation and correlation of serum IL-6 level and intra-abdominal pressure before and after early continuous veno-venous hemofiltration in severe acute pancreatitis patients with abdominal compartment syndrome

Objective To investigate the effect of early continuous veno-venous hemofiltration (CVVH) on intra-abdominal pressure (IAP) and serum interleukin-6 (IL-6) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS) . Methods 41 SAP patients with ACS were selected as treatment group and treated with CVVH as well as conventional methods in ICU. The other 12 patients with the same disease were selected as the control group and were only treated with conventional methods because of economic reasons. IAP and blood level of IL-6 in the two groups were measured daily in order to investigate their changes and the correlation between the two parameters. Results The serum IL-6 level and IAP in the two groups were higher on admission day. IAP and serum IL-6 level in the treatment group were significantly decreased on the first day after treatment, and thereafter decreased rapidly. In the control group, IAP and serum IL-6 level were significantly decreased on the 3rd day after treatment. IAP and serum IL-6 level from the 1st day to the 6th day after treatment in the treatment group were significantly lower than those of the control group at the same time point (P<0.05) . There was a significant positive correlation between blood IL-6 level and IAP in SAP patients with ACS (r=0.48, P<0.01) . IL-6 difference before and after treatment was also positively correlated with the difference of IAP (R=0.39, P<0.05) . Conclusions VVH significantly decreased the IAP and the blood level of IL-6 in ACS patients of SAP. The blood level of IL-6 is significantly correlated with IAP, suggesting that IL-6 may play an important role in the pathogenesis of ACS. Therefore early CVVH may clear the cytokines such as IL-6 and lower IAP, thus to prevent multiple organ dysfunction syndrome (MODS) , which should be applied in the early stage of ACS. Key words: Severe acute pancreatitis; Abdominal compartment syndrome; Intra-abdominal hypertension; Continuous veno-venous hemofiltration; Interleukin-6