title: Early blood purification therapy of severe acute pancreatitis complicated by acute lung injury.
abstract: OBJECTIVE
  Severe acute pancreatitis (SAP) can often be complicated by acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), leading to increased mortality. Early blood purification clears inflammatory cytokines and promotes immune function recovery. Here we evaluated the usefulness of this therapy in SAP complicated by ALI.
  
  
  METHODS
  32 patients received routine treatment (control group), whereas other 32 patients received routine treatment and early blood purification therapy (study group). We evaluated respiratory indexes (PaO2, PaO2/FiO2, alveolar-arterial oxygen difference, intrapulmonary arteriovenous shunt percentage, and respiratory rate), blood biochemical (creatinine, blood urea nitrogen, alanine aminotransferase, and lactate levels) and inflammatory (CRP, IL-10, TNF-α, and IL-10/TNF-α ratio) markers, and prognostic outcomes (multiple organ dysfunction syndrome [MODS] and APACHE II scores) before and 72 hours after the treatment. We also documented mechanical ventilation use, occurrence of MODS and ARDS, and mortality rates.
  
  
  RESULTS
  There were no deaths. Mechanical ventilation was used in a similar percentage of patients in either group. Treatment in study group led to a faster and better recovery of respiratory indexes, and less pronounced changes in the levels of blood urea nitrogen and alanine aminotransferase. Inflammatory markers also normalized better in the study group. Furthermore, MODS and APACHE II scores decreased to a greater extent in the study group, paralleled by a lower occurrence of MPDS and ARDS.
  
  
  CONCLUSIONS
  Early blood purification therapy improves respiratory function and inflammatory markers in patients with SAP complicated by ALI, and decreases the occurrence of MODS and ARDS.
authors.affiliation: Department of Emergency, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China. guohua47629@163.com.
authors.forename: H
authors.initials: H
authors.lastname: Guo
authors.forename: D-W
authors.initials: DW
authors.lastname: Suo
authors.forename: H-P
authors.initials: HP
authors.lastname: Zhu
authors.forename: X-M
authors.initials: XM
authors.lastname: Sun
authors.forename: J
authors.initials: J
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D055371:Acute Lung Injury / Q000097:blood / Q000150:complications / Q000628:therapy*; D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000150:complications / Q000628:therapy; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome