Efficacy of hemoperfusion techniques combined with continuous renal replacement therapy in the treatment of patietnts with severe acute pancreatitis

Cao Xiuli; Zhao Qinghua; Zhao Yongsheng; Wang Bin; Pu Tingjiang; Ge Shengnan; Xin Xianlei; Liu Zhiwei; Ren Weizheng

doi:10.13498/j.cnki.chin.j.ecc.2023.06.08

Abstract：Objective To explore the role of hemoperfusion(HP)techniques combined with continuous renal replacement therapy(CRRT)in the treatment of patients with severe acute pancreatitis(SAP).Methods To retrospectively analyse the thera-peutic efficacy of HP combined with CRRT in SAP patients of PLA General Hospital from January 2022 to April 2023.The dura-tion of HP treatment was 4 h at a time for a period of 1 to 5 days.Each hemoperfusion treatment was performed for 4 hours.The treatment course was 1-5 days.Patients'general conditions including age,gender,body mass index,length of ICU stay,mechani-cal ventilation and circulatory support,and treatment outcome were collected.Comparison of changes in vital signs,C reactive protein,troponin T,brain natriuretic peptide precursor,white blood cell count,and other indicators of changes before perfusion treatment,the day after treatment,and at the end of the treatment course were performed.Results A total of 19 SAP patients were treated with HP combined with CRRT therapy,of which 5 patients were not included in the statistical analysis due to miss-ing post-treatment data.Of the 14 patients treated with HP,8 patients(57.1%)were male and 6 patients(42.9%)were female,with a mean age of 48.1 years and a mean body mass index of 26.5 kg/m2.Seven patients were supported with mechanical venti-lation(50.0%)and 10 patients received circulatory support with vasoactive drugs(71.4%),with a mean ICU stay of 36.4 d.Com-pared with the day of treatment,interleukin-6,brain natriuretic peptide precursor,and total bilirubin were significantly improved 1 d after treatment(P＜0.05).There was a statistically significant improvement in body temperature,interleukin-6,and oxygen-ation index between the end of treatment and the day of treatment(P＜0.05).Eventually 13 patients were discharged cured and 1 died while in hospital(7.2%).Conclusion HP combined with CRRT can effectively reduce brain natriuretic peptide precursors and lactate,and improve oxygenation index in patients with severe acute pancreatitis.