[Indications for and clinical efficacy of continuous hemodiafiltration (CHDF) for severe acute pancreatitis].
It has been claimed humoral mediator network including pro-inflammatory cytokines plays a pivotal role in the pathophysiology of SAP. On the other hands, we have reported CHDF using polymethyl methacrylate (PMMA) membrane hemofilter could remove cytokines in blood of a patient continuously and effectively. Therefore, we applied CHDF to patients with SAP. CHDF was performed using a PMMA-hemofilter for removal of causative cytokines regardless of renal function 24 hours a day without interruption until IL-6 blood level became below 400 pg/ml. Selective digestive decontamination (SDD) was also given for prevention of bacterial translocation. Forty-two out of 45 patients (93%) receiving both CHDF and SDD survived. We conclude critical care with PMMA-CHDF and SDD is an effective treatment for SAP.
Hirasawa
Hiroyuki
H
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University.
Oda
Shigeto
S
Shiga
Hidetoshi
H
Matsuda
Kenichi
K
Abe
Ryuzo
R
D000208:Acute Disease; D000818:Animals; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000302:isolation & purification; D003666:Decontamination / Q000379:methods; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D018836:Inflammation Mediators / Q000302:isolation & purification; D015850:Interleukin-6 / Q000097:blood / Q000302:isolation & purification; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D019904:Polymethyl Methacrylate; D012372:ROC Curve; D012720:Severity of Illness Index
D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D015850:Interleukin-6; D019904:Polymethyl Methacrylate