Continuous Hemofiltration Reduces Mortality in Severe Acute Pancreatitis: A Meta-Analysis

Abstract

Background. Severe acute pancreatitis (SAP) is a deadly condition, with a mortality rate ranging from 15% to 30%. Recently, blood purification therapy has been adopted in administrating SAP patients. The present study aimed at evaluating the effect of continuous hemofiltration therapy for SAP. Methods. A systematic search of Cochrane Library, PubMed, and Embase was carried out until October 1st, 2019. Prospective studies comparing outcomes for SAP patients between continuous hemofiltration and standard therapy were enrolled. Results. Continuous hemofiltration therapy was associated with lower level of PACHE II score (MD = −1.49; 95% CI: −2.69 to −0.29, P=0.02), CRP (MD = −1.56 mg/L; 95% CI: −2.64 to −0.47, P=0.005), Cr (MD = −3.57 umol/L; 95% CI: −5.50 to −1.65, P=0.003), and Bun (MD = −3.63 mmol/L; 95% CI: −6.07 to −1.20, P=0.003) at 72 h after onset of treatment. Continuous hemofiltration therapy was associated with shorter length of abdominal pain relief time (MD = −1.82 hours; 95% CI: −2.93 to −0.71, P=0.001), lower surgery rate (OR = 0.15; 95% CI: 0.03 to 0.78, P=0.02), and mortality rate (OR = 0.54; 95% CI: 0.37 to 0.77, P=0.0007). Conclusions. continuous hemofiltration therapy could effectively alleviate SAP as early as 72 hours after onset of treatment, lowering the level of Bun, Cr, CRP, and APACHE II scores. Continuous hemofiltration therapy could confer SAP patients with lower mortality rates.

Peritoneal Dialysis Complicated by Severe Acute Pancreatitis: A Case Report

“…[1] SAP often leads to multiple organ dysfunction syndrome with high mortality rates. [2] Here we present a case of SAP complicated by peritoneal dialysis (PD) and extensively examine the relevant literature. Here we aimed to offer clinical insights by summarizing the diagnostic and treatment experiences related to SAP with PD complications.…”

CT Image Features Based on the Reconstruction Algorithm for Continuous Blood Purification Combined with Nursing Intervention in the Treatment of Severe Acute Pancreatitis

“…SAP is one of the common critical illnesses in the emergency department. Active inflammatory factors in the body during the onset lead to the release of a large number of cytokines, leading to the aggravation of the disease [ 2 ]. The secondary infection of the pancreas and the peripancreatic tissue further develops into multiple organ failure, which seriously threatens the life of patients and produces a higher mortality [ 3 ].…”

High‐volume hemofiltration reduces short‐term mortality with no influence on the incidence of MODS, hospital stay, and hospitalization cost in patients with severe‐acute pancreatitis: A meta‐analysis

“…The second meta‐analysis 10 (2019) included only one study to evaluate a single outcome. The third one 11 (2020) included nine studies, five of which reported mortality data. One of the five studies reported the mortality in the BP group but not in the control group, and the remaining four studies used APACHII grade for mortality analysis.…”

“…Since 2010, three meta‐analyses on the efficiency of BP have been published, 9‐11 which were focused on different outcomes and shared differences inclusion criteria. For example, the included studies with the outcomes ranged from laboratory parameters to APACHE‐II score, included study's numbers shifted from two to nine.…”

“…Even in the Japan guideline, BP is only recommended to reduce proinflammatory cytokines in cases with abdominal compartment syndrome or with unstable circulation dynamics and anuria after sufficient initial fluid infusion. 7,8 Since 2010, three meta-analyses on the efficiency of BP have been published, [9][10][11] which were focused on different outcomes and shared differences inclusion criteria. For example, the included studies with the outcomes ranged from laboratory parameters to APACHE-II score, included study's numbers shifted from two to nine.…”