Continuous high-volume hemofiltration on C-reactive protein in severe acute pancreatitis

Objective:The acute-phase reactant C-reactive protein (CRP) is a marker of inflammatory response, it is currently a serum variable of choice for early and accurate assessment of severity in severe acute pancreatits (SAP) This study was performed to evaluate the influence of continuous high-volume hemofiltration (CHVHF) on serum CRP levels in SAP patients Twenty-three SAP patients(15 males and 8 females) with an average age of 27～73(47 7±13 6) were included CHVHF was started 1～7(3 48±1 45)days after onset of the disease, APACHE II score before the treatment was 6～20(11 6±4 36) Twenty-two of the patients were complicated with acute respiratory distress syndrome/acute pulmonary injury(ARDS/API), and in 13 of them mechanical ventilation was needed Five of the patients complicated with acute renal failure(ARF), and 5 patients with shock CHVHF was performed continuously for 67～76 hours, AN69 hemofilters (1 2 m 2) were used and changed every 24 hours The ultrafiltration rate was (3 966 4±240 2)ml/h Clinical symptoms of SAP were relieved quickly on CHVHF, including decreased body temperature, heart rate and increased arterial oxygen concentration Twenty (87 0%) of the patients survived, and 3 (13 0%) patients died The APACHE Ⅱ scores were significantly decreased in the survivals but not significant in the non-survivals CRP level decreased gradually in the survivals, 48h after CHVHF it was significantly lower than pre-treatment ( P 0 05), and very significantly lower than pre-treatment 60h and 72h after CHVHF ( P 0 01) While in the dead 3 patients, CRP was decreased in only one of them, but increased in the other 2 patients No correlation was found between CRP and APACHE II score in the two groups.CHVHF was effective in alleviating symptoms of SAP and decreasing the acute-phase reactant CRP level in the SAP patients Sequential determination of CRP serum levels in SAP patients treated with CHVHF is of clinical significance in the evaluation of the prognosis