Effects of short veno-venous hemofiltration on severe acute pancreatitis

OBJECTIVE: To estimate the effects of therapy of short veno-venous hemofiltration (SVVH, 4hr) on severe acute pancreatitis (SAP). METHODS: Twenty patients were divided randomly into hemofiltration group (HF, 10 pts) and non-hemofiltration group (NHF, 10 pts). The local, systemic manifestations were compared between two groups; and the concentration of serum pro-inflammatory cytokines (TNFalpha, IL-1beta, IL-6, IL-8, sIL-2R) and anti-inflammatory cytokines (IL-2, IL-10) were determined at different observation points. RESULTS: In the HF and NHF group, the duration for disappearance of abdominal pain and tenderness, and amelioration for abdominal distension was (8.5 +/- 6.3) d vs. (90.0 +/- 49.0) d and (16.9 +/- 5.2) d vs. (63.4 +/- 36.0) d. CT scores at the 14th day and APACHE II scores at the 10th day was (5.6 +/- 1.3) vs. (7.7 +/- 0.8) and (4.5 +/- 1.5) vs. (7.4 +/- 2.1). The average hospital stay and cost of therapy were (33.0 +/- 20.7) d vs. (56.4 +/- 16.0) d and (53,200 +/- 16,000) vs. (89,100 +/- 25,000) RMB (P < 0.05). The concentration of 5 serum pro-inflammatory cytokines at each observation points after hemofiltration was decreased significantly (P < 0.05) in the HF group. But the concentration of the two serum anti-inflammatory cytokines was increased significantly (P < 0.05) as compared with that of the NHF group. CONCLUSIONS: Through SVVH, the imbalance of pro-inflammatory and anti-inflammatory cytokines has been corrected at early stage; thus, the severity of the disease is ameliorated significantly and the efficacy of therapy is increased.