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Is Continuous Venovenous Hemofiltration Effective Against Severe Acute Pancreatitis?
Author(s) -
Wang Shiqi,
Xu Lei,
Feng Xiangying,
Li Shujun,
Feng Quanxin,
Liu Chaoxu,
Zhang Xujie,
Zhao Qingchuan
Publication year - 2013
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12051
Subject(s) - medicine , acute pancreatitis , hemofiltration , intensive care medicine , pancreatitis , hemodialysis
Our aim was to investigate the efficacy of continuous venovenous hemofiltration ( CVVH ) in treating severe acute pancreatitis ( SAP ). A literature search was performed using P ub M ed (1992–present), and all studies investigating the efficacy of CVVH in treating SAP were included. Four comparative studies and seven case series comprising a total of 354 patients were included. The overall mortality rate of patients receiving CVVH was 20% (55/275). A decreased mortality rate and decreased serum cytokine levels were reported in the CVVH groups in only two studies. The starting time point, substitution fluid flow rate, filter membrane type, hemofilter change interval, anticoagulation, and sustaining times of CVVH varied among the studies, and the impact of these parameters on the efficacy of CVVH was poorly reported. High‐volume CVVH , when started early, was demonstrated to be more effective in eliminating cytokines in only one study. After the application of CVVH , the patient conditions started to improve between the 6th and 72nd hours. In conclusion, no solid clinical evidence has proven the efficacy of CVVH in treating SAP . High‐volume CVVH that is started early and sustained for at least 72 h may be adopted to investigate the efficacy of CVVH for treating SAP .