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 (PaO2/FiO2), 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.
*Department of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences
†Southern Medical University, Guangzhou, People's Republic of China
W.S. and C.H. designed the study; C.H. and L.Z. performed all the experiments and wrote the paper; X.L. and Z.Y. performed partly the immunoassays and data collection; B.Z. performed the statistical analyses; S.L. revised the paper. All the authors read and approved the final manuscript.
C.H. and L.Z. contributed equally.
The authors declare that they have nothing to disclose.
Supported by grants from Science and Technology Planning Project of Guangdong Province, China (2007B031507008; 2004B 30701006) and Medical Scientific Research Foundation of Guangdong Province, China (A2006028).
Reprints: Wei Shi, PhD, Department of Nephrology, Guangdong General Hospital, Southern Medical University, Guangzhou 510080, Guangdong, People’s Republic of China (e-mail: email@example.com).
Received January 16, 2012
Accepted June 27, 2012