Effects of time interval for hemofiltration on the prognosis of severe acute pancreatitis.
OBJECTIVE
To evaluate the impact of time interval for hemofiltration (HF) on the prognosis of severe acute pancreatitis (SAP).


METHODS
Thirty-six consecutive patients with severe acute pancreatitis were included in the study. Atlanta classification system was applied for stratification. They were randomly divided into short veno-venous HF group, (SVVH, Group 1, 20 patients); and long veno-venous HF group (LVVH, Group 2, 16 patients). In group 1, SVVH was stopped when the abdominal signs disappeared, and heart rate and breath rate were less than 90 beats/min and 20 times/min, respectively. HF was stopped if SVVH was continued, and when heart rate and breath rate were more than 90 beats/min and 20 times/min again (Group 2). Except that the time interval for HF was different, other parameters for HF were the same. And conservative curing rate, survival rate, cost for hospital stay and length of hospital stay were observed.


RESULTS
Time interval for HF in Group 1 (3.81+/-1.3 hr) was shorter than that of in Group 2 (9.38+/-2.9 hr), P<0.01. Conservative curing rate (90 %) in Group 1 was much higher than that in Group 2 (56.3 %) (P<0.05); but cost in Group 1 (RMB 56 600+/-56 400 Yuan) was lower than that in Group 2 (RMB 137 000+/-105 000 Yuan) (P<0.05). And the survival rate (95 %) in Group 1 was higher than that in Group 2 (81.3 %) (P<0.25); however, hospital stay in Group 1 (44.3+/-41 days) was shorter than that in Group 2 (55.2+/-39.5 days) (P<0.2). So, the prognosis was not improved through the prolongation of time interval for HF, but side-effects were seen.


CONCLUSIONS
The prognosis was not further improved by LVVH in the treatment of SAP, with side-effects. Time interval for HF plays an important role in treatment of SAP in early stage. SVVH is thought to be superior to LVVH; and LVVH is superior to CVVH in early (72 hrs) treatment of SAP.
Mao
En-Qiang
EQ
Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. maoeq@yeah.net
Tang
Yao-Qing
YQ
Zhang
Sheng-Dao
SD
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000503:physiopathology* / Q000628:therapy*; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors