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High-volume hemofiltration plus hemoperfusion for hyperlipidemic severe acute pancreatitis: a controlled pilot study

time :  2017-01-16

Shiren Sun, Lijie He, Ming Bai, Hongbao Liu, Yangping Li, Li Li, Yan Yu, Meilan Shou, Rui Jing, Liyuan Zhao, Chen Huang, Hanmin Wang

From the Department of Nephrology, Xijing Hospital, the Fourth Military Medical University, Xi’an, Shaanxi, China

Correspondence: Dr. Shiren Sun · Department of Nephrology, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi’an, Shhanxi 710032, China 


Background and Objectives: The evidence for high-volume hemofiltration plus hemoperfusion (HVHF&HP) for hyperlipidemic severe acute pancreatitis (HL-SAP) is anecdotal. The purpose of our study was to evaluate the efficacy of HVHF&HP for HL-SAP in a prospective controlled study.

Design and Setting: Prospective controlled pilot study between May 2010 and May 2013 in a hospital intensive care unit.

Patients and Methods: HL-SAP patients chose conventional treatment alone (the control group) or conventional treatment combined with the experimental protocol (the HVHF&HP group) and were prospectively followed in our hospital. APACHE II score, SOFA score, ICU and hospital stay duration, and serum biomarkers were considered endpoints.

Results: Ten HL-SAP patients accepted conventional treatment alone (the control group) and 10 patients underwent HVHF&HP combined with conventional treatment (the HVHF&HP group). The APACHE II score, SOFA score, systolic blood pressure, diastolic blood pressure, heart rate, serum amylase, and serum creatinine were significantly reduced after the HVHF&HP treatment. The changes in these variables were significantly different between the HVHF&HP and control group at 48 hours after the initiation of treatment. Patients in the HVHF&HP group had a significantly shorter ICU stay (P=.015). The reduction in serum triglyceride and cholesterol in the HVHF&HP group after 2, 6, 12, 24, and 48 hours was greater than the control group. All of the tested serum cytokines were significantly decreased after HVHF&HP treatment (P<.05). However, in patients who underwent conventional treatment alone, there was no significant change in the serum cytokines.

Conclusion: This study suggests that the addition of HVHF&HP to conventional treatment for HL-SAP patients may be superior to conventional treatment alone for the improvement of serum biomarkers and clinical outcomes.


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