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Annals of Saudi medicine · Sep 2015
Controlled Clinical TrialHigh-volume hemofiltration plus hemoperfusion for hyperlipidemic severe acute pancreatitis: a controlled pilot study.
- Shiren Sun, Lijie He, Ming Bai, Hongbao Liu, Yangping Li, Li Li, Yan Yu, Meilan Shou, Rui Jing, Liyuan Zhao, Chen Huang, and Hanmin Wang.
- Dr. Shiren Sun, Department of Nephrology,, Xijing Hospital,, The Fourth Military Medical University,, No. 127 Changle West Road,, Xi'an, Shhanxi 710032, China, T: +8602984775193, F: +8602984773494, shirensunfmmu@163.com.
- Ann Saudi Med. 2015 Sep 1; 35 (5): 352-8.
Background And ObjectivesThe evidence for high-volume hemofiltration plus hemoperfusion (HVHF&HP) for hyperlipidemic severe acute pancreatitis (HL-SAP) is anecdotal. The purpose of our study was to evaluate the efficacy of HVHF&HP for HL-SAP in a prospective controlled study.Design And SettingProspective controlled pilot study between May 2010 and May 2013 in a hospital intensive care unit.Patients And MethodsHL-SAP patients chose conventional treatment alone (the control group) or conventional treatment combined with the experimental protocol (the HVHF&HP group) and were prospectively followed in our hospital. APACHE II score, SOFA score, ICU and hospital stay duration, and serum biomarkers were considered endpoints.ResultsTen HL-SAP patients accepted conventional treatment alone (the control group) and 10 patients underwent HVHF&HP combined with conventional treatment (the HVHF&HP group). The APACHE II score, SOFA score, systolic blood pressure, diastolic blood pressure, heart rate, serum amylase, and serum creatinine were significantly reduced after the HVHF&HP treatment. The changes in these variables were significantly different between the HVHF&HP and control group at 48 hours after the initiation of treatment. Patients in the HVHF&HP group had a significantly shorter ICU stay (P=.015). The reduction in serum triglyceride and cholesterol in the HVHF&HP group after 2, 6, 12, 24, and 48 hours was greater than the control group. All of the tested serum cytokines were significantly decreased after HVHF&HP treatment (P < .05). However, in patients who underwent conventional treatment alone, there was no significant change in the serum cytokines.ConclusionThis study suggests that the addition of HVHF&HP to conventional treatment for HL-SAP patients may be superior to conventional treatment alone for the improvement of serum biomarkers and clinical outcomes.
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