Effects of early high-volume hemofiltration on severe acute pancreatitis patients with respiratory distress syndrome

ObjectiveTo assess the efficacy of early high-volume hemofiltration (HVHF) on severe acute pancreatitis (SAP) patients with acute respiratory distress syndrome (ARDS). MethodsA total of 30 SAP patients with ARDS were enrolled into the study. The patients were randomly divided into a treatment group and a control group (n=15). With mechanical ventilation as the starting point, the levels of tumor necrosis factor α (TNF-α) and interleukin-10 (IL-10), and respiratory rate (RR), oxygenation index, arterial partial pressure of carbon dioxide, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were measured on 0, 12, 24, 36, 48, 60 and 72 h. The time of mechanical ventilation, ICU and hospitalization stay, mortality in hospital and within 28 days were also recorded. ResultsAfter hemofiltration, the treatment group produced decreased levels of TNF-α and IL-10 compared with the levels before treatment (P<0.05) and those in the control group on 24, 36, 48, 60 and 72 h (P<0.05). After treatment, oxygenation index was increased in both groups compared with the levels before treatment, where the treatment group showed remarkably a higher oxygenation index than the control on 24, 36, 48, 60 and 72 h (P<0.05). After treatment, RR was decreased in both groups compared with the levels before treatment, where the treatment group showed remarkably lower RR than the control on 60 and 72 h (P<0.05). The time of mechanical ventilation was markedly shortened in the treatment group compared with the control (P<0.05). After treatment, APACHE Ⅱ was decreased in both groups compared with the levels before treatment, where the treatment group showed remarkably lower APACHE Ⅱ than the control on 12, 24, 36, 48, 60 and 72 h (P<0.05). Furthermore, the treatment group required shorter ICU and hospitalization stay than the control (P<0.05). However, no statistical difference was found as to mortality in hospital and within 28 days between the two groups (P>0.05). ConclusionsEarly HVHF can clear the inflammatory factors within the circulation of SAP patients with ARDS, improve the respiratory function, relieve the syndromes, and reduce ICU and hospitalization stay.