Effects of early hemofiltration on organ function and intra-abdominal pressure in severe acute pancreatitis patients with abdominal compartment syndrome

Clin Nephrol. 2019 Nov;92(5):243-249. doi: 10.5414/CN109435.

Abstract

Objective: To study the effects of early continuous veno-venous hemofiltration (CVVH) on organ function and intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).

Materials and methods: 48 SAP patients with ACS were included in this study. Among them, 37 patients, receiving both conventional treatment and hemofiltration therapy in the ICU, were regarded as the treatment group, and the rest, receiving only conventional treatment, were regarded as the control group. Symptoms, signs, and adverse reactions of both groups were observed and recorded during treatments. Serum and urine amylase, liver and kidney function, C-reactive protein, and intra-abdominal pressure of the patients were detected before and on days 1, 2, 3, 4, 5, and 6 after treatment.

Results: 1. Symptoms and signs in the treatment group disappeared quickly, and their hospitalization time was significantly shorter than those of control group (p < 0.05). 2. After treatment, on days 1, 2, 3, 4, 5, and 6, patients' serum and urine amylase levels, C-reactive protein, and intra-abdominal pressure were significantly lower, and liver and kidney function was significantly better than those of the control group (p < 0.05).

Conclusion: Early hemofiltration in SAP with ACS can effectively reduce intra-abdominal pressure, improve symptoms, accelerate liver and renal function recovery, avoid multiple organ failure and decrease mortality rate.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hemofiltration*
  • Humans
  • Intra-Abdominal Hypertension* / etiology
  • Intra-Abdominal Hypertension* / physiopathology
  • Intra-Abdominal Hypertension* / therapy
  • Male
  • Middle Aged
  • Pancreatitis* / complications
  • Pancreatitis* / physiopathology
  • Pancreatitis* / therapy