Effects of Continuous High-Volume Hemofiltration on Experimental Severe Acute Pancreatitis in Pigs

Li, Weiqin; Yan, Xiaowen; Wang, Hao; Zhang, Zhenhuan; Yu, Wenkui; Ji, Daxi; Gong, Dehua; Quan, Zhu-Fu; Li, Jieshou

doi:10.1097/01.mpa.0000240605.03441.1f

Cited by 21 publications

(12 citation statements)

References 28 publications

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“…Membranes made from polymethylmethacrylate have a high cytokine-adsorbing capacity (30), whereas membranes made from polysulfone do not perform as well in this respect (22). Third, the duration of hemofilter use also has an impact on the outcomes of patients treated by CVVH (31,32). It would be better if the filter could be changed before it reaches its adsorptive saturative time (12).…”

Section: Figmentioning

confidence: 95%

Early Classic Hemofiltration Exhibits No Benefits in Severe Acute Pancreatitis With Early Organ Failure: A Retrospective Case-Matched Study

Zhang

Sun

et al. 2013

Artificial Organs

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Continuous venovenous hemofiltration (CVVH) is an important organ supportive technique. This study aimed to evaluate the impact of early classic CVVH on the outcomes of severe acute pancreatitis (SAP) patients with early organ failure (EOF). Between 2008 and 2012, a total of 44 SAP patients with EOF were admitted to our department. The 44 patients were classified into two groups according to whether they received early classic CVVH (2 L/h, initiated within 24 h after admission): 25 patients received early CVVH (ECVVH group), and 19 patients did not receive early CVVH (control group). The two groups were matched for age and Acute Physiology and Chronic Health Evaluation II scores. The severity of organ dysfunctions was evaluated by Sequential Organ Failure Assessment (SOFA) scores. Each group included 19 patients. The baseline characters between the two groups were balanced. The SOFA scores in the ECVVH group increased compared with those in the control group. The time to weaning from mechanical ventilation was significantly longer in the ECVVH group (log-rank test: χ(2) = 4.007, P = 0.045). Renal support was also significantly prolonged in the ECVVH group (the number of patients receiving CVVH 72 h after admission: 10 vs. 3, respectively, P = 0.038). Nine patients died in the ECVVH group versus six patients in the control group (P = 0.508). In conclusion, our study failed to prove that early classic CVVH had any benefits on the outcomes of SAP patients with EOF. Unexpectedly, early classic CVVH worsened organ functional capacity. However, it is possible that CVVH using advanced techniques may be beneficial in SAP patients with EOF.

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Section: Figmentioning

confidence: 95%

Early Classic Hemofiltration Exhibits No Benefits in Severe Acute Pancreatitis With Early Organ Failure: A Retrospective Case-Matched Study

Zhang

Sun

et al. 2013

Artificial Organs

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“…Evidence accumulated over the last years demonstrate that continuous venovenous hemofiltration (CVVH) is of benefit for SAP, because of its removal of inflammatory molecules (6–8). Particular attention has been paid to high‐volume hemofiltration (HVHF), which might be better (9). But HVHF requires high blood flow, tight ultrafiltration (UF) control and large amounts of expensive sterile fluids.…”

mentioning

confidence: 99%

Clinical Effects of Pulse High‐Volume Hemofiltration on Severe Acute Pancreatitis Complicated With Multiple Organ Dysfunction Syndrome

Chu¹,

Jun-jing²,

Yu³

et al. 2012

Ther Apher Dial

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To evaluate the effects of pulse high-volume hemofiltration (PHVHF) on severe acute pancreatitis (SAP) with multiple organ dysfunction syndrome (MODS). Thirty patients were divided into two groups: PHVHF group and continuous venovenous hemofiltration (CVVH) group. They were evaluated in terms of clinical symptoms, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, simplified acute physiology (SAPS) II score and biochemical changes. The levels of IL-6, IL-10 and TNF-α in plasma were assessed by ELISA before and after treatment. The doses of dopamine used in shock patients were also analyzed. In the two groups, symptoms were markedly improved after treatment. Body temperature (BT), breath rate (BR), heart rate (HR), APACHE II score, SOFA score, SAPS II score, serum amylase, white blood cell count and C-reactive protein were decreased after hemofiltration (P < 0.05). The PHVHF group was superior to the CVVH group, especially in APACHE II score, CRP (P < 0.01), HR, temperature, SOFA score and SAPS II score (P < 0.05). The doses of dopamine for shock patients were also decreased in the two groups (P < 0.05), with more reduction in the PHVHF group than the CVVH group (P < 0.05). The levels of IL-6, IL-10 and TNF-α decreased (P < 0.05) in the PHVHF group more significantly than the CVVH group (P < 0.01). PHVHF appears to be superior to CVVH in the treatment of SAP with MODS.

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“…29Y33 Previous studies have demonstrated that it is possible to induce rat necrotizing pancreatitis by injecting a single dose of sodium taurocholate into the pancreatic duct. 34 However, Adler et al 30 and Li et al 35 found that the increase in active enzyme concentrations accelerated lytic necrosis of the pancreas. In the present experiment, the overall success rate of the SAP model was 88.9% when swine were injected with sodium taurocholate (5%) that was enhanced with trypsin (5%).…”

Section: Discussionmentioning

confidence: 97%

Establishment of a Secondary Infection Model of Severe Acute Pancreatitis in Swine

Wang

Shao²,

Zuo³

et al. 2011

Pancreas

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Effects of Continuous High-Volume Hemofiltration on Experimental Severe Acute Pancreatitis in Pigs

Abstract: The HVHF was associated with a better hemodynamic profile, a less hyperkinetic state, and more prolonged survival than that of LVHF, which may result from the HVHF that can remove the inflammatory cytokines more efficiently.

Cited by 21 publications

References 28 publications

Early Classic Hemofiltration Exhibits No Benefits in Severe Acute Pancreatitis With Early Organ Failure: A Retrospective Case-Matched Study

Early Classic Hemofiltration Exhibits No Benefits in Severe Acute Pancreatitis With Early Organ Failure: A Retrospective Case-Matched Study

Clinical Effects of Pulse High‐Volume Hemofiltration on Severe Acute Pancreatitis Complicated With Multiple Organ Dysfunction Syndrome

Establishment of a Secondary Infection Model of Severe Acute Pancreatitis in Swine

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