Adjunctive Continuous High-Volume Hemofiltration in Patients With Acute Severe Pancreatitis

医学 急性胰腺炎 血液滤过 重症监护室 急性肾损伤 胰腺炎 麻醉 内科学 血液透析
作者
Yilin Zhu,Jing Yuan,Ping Zhang,Xiao Hu,Qiang He,Fei Han,Jianghua Chen
出处
期刊:Pancreas [Ovid Technologies (Wolters Kluwer)]
卷期号:40 (1): 109-113 被引量:21
标识
DOI:10.1097/mpa.0b013e3181f83019
摘要

To evaluate the efficacy of adjunctive continuous high-volume hemofiltration (HVHF) in patients with severe acute pancreatitis.Seventy-five patients admitted to the intensive care unit for severe acute pancreatitis from July 2006 to May 2009 were given informed consent and were followed prospectively. Patients were divided into 4 groups according to whether they accepted continuous HVHF (42 vs 33) and if they showed signs of acute kidney injury.Patients of the 4 groups were comparable at baseline. The 28-day survival rate was higher in patients who accepted HVHF (81% vs 57.6%, P=0.026), especially in those without acute kidney injury (95% vs 66.7, P=0.026). Furthermore, after 72 hours of therapy, the patients who accepted HVHF had significantly better Acute Physiology and Chronic Health Evaluation II scores (16.8±4.37 vs 13.39±3.17; P<0.05), body temperature (38.2°C±1.01°C vs 37.73°C±0.95°C; P<0.05), urine volume (1186±841 mL vs 2381±2462 mL; P<0.05), and base excess (-6.3±4.5 vs 0.64±3.4; P<0.05). However, the improvement in patients who did not accept HVHF was not so obviously.High-volume hemofiltration was associated with improved clinical outcome in acute pancreatitis patients, and should be initiated before kidney injury appearance.

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