title: Coupled plasma filtration adsorption combined with continuous veno-venous hemofiltration treatment in patients with severe acute pancreatitis.
abstract: BACKGROUND
  Severe acute pancreatitis (SAP) still has a high mortality rate. Coupled plasma filtration adsorption (CPFA) and continuous veno-venous hemofiltration (CVVH) are 2 extracorporeal blood purification techniques. We hypothesized that CPFA combined with CVVH could preferentially improve prognosis and suppress clinical manifestations of SAP.
  
  
  METHODS
  In this observational cohort study, 25 patients with SAP were enrolled, in which 12 received CPFA plus CVVH treatment (group 1), and 13 received CVVH therapy (group 2). All the patients underwent a successive 10-day intervention. Clinical indicators were detected before or after the intervention and the results were compared between the 2 groups. The feasibility and the survival rate were evaluated on day 28.
  
  
  RESULTS
  Compared with group 2, oxygenation index (PaO(2)/FiO(2)), mean arterial pressure, serum amylase, and blood urine nitrogen showed significant differences (all P<0.01) and serum TNF-α, IL-1β, IL-6 were reduced and IL-10 was elevated with time in group 1 (all P<0.01). Liver functions, electrolyte, and acid-base balance did not show significant difference before and after the 10-day treatment with CPFA plus CVVH compared with CVVH (P>0.05). No therapy-related adverse reactions were noted in both groups. Twenty-eight-day survival rate of group 1 was higher than that in group 2 [91.7% (11/12) vs. 53.8% (7/13), P<0.05].
  
  
  CONCLUSIONS
  CPFA combined with CVVH was an effective and safe method for treatment of SAP patients, the mechanism being related to its effect on regulating the level of cytokines and serum amylase.
authors.affiliation: Department of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Chaosheng
authors.initials: C
authors.lastname: He
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Xinling
authors.initials: X
authors.lastname: Liang
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Ye
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Shuangxin
authors.initials: S
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D000681:Amylases / Q000097:blood; D015415:Biomarkers; D001795:Blood Pressure Determination; D001806:Blood Urea Nitrogen; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010195:Pancreatitis / Q000097:blood / Q000473:pathology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000681:Amylases; D010100:Oxygen