title: Early classic hemofiltration exhibits no benefits in severe acute pancreatitis with early organ failure: a retrospective case-matched study.
abstract: Continuous venovenous hemofiltration (CVVH) is an important organ supportive technique. This study aimed to evaluate the impact of early classic CVVH on the outcomes of severe acute pancreatitis (SAP) patients with early organ failure (EOF). Between 2008 and 2012, a total of 44 SAP patients with EOF were admitted to our department. The 44 patients were classified into two groups according to whether they received early classic CVVH (2 L/h, initiated within 24 h after admission): 25 patients received early CVVH (ECVVH group), and 19 patients did not receive early CVVH (control group). The two groups were matched for age and Acute Physiology and Chronic Health Evaluation II scores. The severity of organ dysfunctions was evaluated by Sequential Organ Failure Assessment (SOFA) scores. Each group included 19 patients. The baseline characters between the two groups were balanced. The SOFA scores in the ECVVH group increased compared with those in the control group. The time to weaning from mechanical ventilation was significantly longer in the ECVVH group (log-rank test: χ(2)  = 4.007, P = 0.045). Renal support was also significantly prolonged in the ECVVH group (the number of patients receiving CVVH 72 h after admission: 10 vs. 3, respectively, P = 0.038). Nine patients died in the ECVVH group versus six patients in the control group (P = 0.508). In conclusion, our study failed to prove that early classic CVVH had any benefits on the outcomes of SAP patients with EOF. Unexpectedly, early classic CVVH worsened organ functional capacity. However, it is possible that CVVH using advanced techniques may be beneficial in SAP patients with EOF.
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Xujie
authors.initials: X
authors.lastname: Zhang
authors.forename: Shiren
authors.initials: S
authors.lastname: Sun
authors.forename: Shujun
authors.initials: S
authors.lastname: Li
authors.forename: Xiangying
authors.initials: X
authors.lastname: Feng
authors.forename: Shiqi
authors.initials: S
authors.lastname: Wang
authors.forename: Chaoxu
authors.initials: C
authors.lastname: Liu
authors.forename: Zhenning
authors.initials: Z
authors.lastname: Hang
authors.forename: Chao
authors.initials: C
authors.lastname: Tong
authors.forename: Cailin
authors.initials: C
authors.lastname: Zhu
authors.forename: Bin
authors.initials: B
authors.lastname: Bai
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Quanxin
authors.initials: Q
authors.lastname: Feng
authors.forename: Qingchuan
authors.initials: Q
authors.lastname: Zhao
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Hemofiltration; Organ failure; Severe acute pancreatitis