The clinical study of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis

Objective:To explore the efficacy and mechanism of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis(SAP).Methods:21 consecutive patients with SAP were included in this study.They were administrated with central venous catheteration.AV600 hemofilter(1.4m~2) was applied for CVVH.CVVH was started 2.8±1.4 days after onset of disease and sustained for 44.6±30.7 hours.We monitored the changes of symptorm,physical sign,laboratory examination and cytokines during CVVH.Results:The hemodynamic state in all patients was stable during CVVH.The overall surviral rate in ICU reached to 76.2%.After implement of the CVVH treatment,abdominal pain and abdominal distension were considerably improved.Temperature,heart rate,breath rate decreased significantly,as well as serum concentrations of BUN,Cr,ALT,ALP,AMY,LPS declined.There was a considerable reduction in cytokines including TNF-α,IL-6,γ-INF at the end of CVVH treatment.Conclusion:CVVH is an effective therapeutic option in treatment of SAP.The early clearance of inflammatory mediators including TNF-α,IL-6,and γ-INF is thought to be an important mechanism for improving outcome.