Adjunctive continuous high-volume hemofiltration in patients with acute severe pancreatitis: a prospective nonrandomized study.
OBJECTIVE
To evaluate the efficacy of adjunctive continuous high-volume hemofiltration (HVHF) in patients with severe acute pancreatitis.


METHODS
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.


RESULTS
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.


CONCLUSIONS
High-volume hemofiltration was associated with improved clinical outcome in acute pancreatitis patients, and should be initiated before kidney injury appearance.
Zhu
YiLin
Y
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, PR China.
Yuan
Jing
J
Zhang
Ping
P
Hu
Xiao
X
He
Qiang
Q
Han
Fei
F
Chen
Jianghua
J
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate