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.
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, PR China.
YiLin
Y
Zhu
Jing
J
Yuan
Ping
P
Zhang
Xiao
X
Hu
Qiang
Q
He
Fei
F
Han
Jianghua
J
Chen
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