Continuous Veno-Venous Hemofiltration In Treatment Of Severe Acute Pancreatitis

Objective In this study, we cooperated continuous veno-venous hemofiltration in treatment of severe acute pancreatitis (SAP) and investigated the efficacy of CVVH in treatment of SAP. Methods 21 SAP patients were involved, complications of SAP before CVVH including SIRS in 21 patients , Shock in 11 patients , ARDS in 15 patients , ARF in 9 patients and pancreatitic encephalopathy in 6 patients . CVVH was sustained for at least 24 hours , AV600s hemofilter (1.4 m2) was applied and changed 24 hours. During CVVH, the patients`conditions and markers of biochemistry were observed. Serum concentrations of endotoxin were measured. Results During CVVH, the patients`hemodynamics were stable. After CVVH, the patients`symptoms such as tachycardia, respiratorydistress, abdominal pain, abdominal distention, fidgety, febrile were remission. APACHE â…¡score decreased significantly. After six hours of CVVH, serum concentration of endotoxin were decreas significantly, but after 24 hours of CVVH, serum concentration of endotoxin were recovery. Six patients died, The mortality rate was 29%. Conclusion 1. Once SIRS happened , CVVH is applied on treatment of SAP immediately . This is in order to interrupt inflammatory reaction and decrease complications occurrenc. 2. During CVVH, the patients`hemodynamics are stable. CVVH can remove lungs` interstitial edema and maintenance water-electrolure balance, acid-base balance. CVVH can improve azotemia and stabiliz internal milieu. 3. CVVH enhance success rate of SAP with MODS and decrease mortality rate.