Efficacy of continuous renal replacement therapy in the treatment of severe acute pancreatitis associated acute respiratory distress syndrome

H.-X. Cui, J.-Y. Xu, M.-Q. Li

Department of General Surgery, Xuzhou Center Hospital, Xuzhou, Jiangsu, China. cuihx2009@126.com

---

• Gastroenterology

OBJECTIVE: To investigate the efficacy of the treatment of severe acute pancreatitis (SAP) complicated by acute respiratory distress syndrome (ARDS) using continuous renal replacement therapy (CRRT) by evaluating the effect of CRRT on respiratory and circulatory function as well as serum cytokines level.

PATIENTS AND METHODS: Fifty four randomly selected patients with confirmed SAP complicated by ARDS after being admitted to intensive care unit (ICU) within 72 hr of onset were included in the study. Patients received mechanical respiratory support and CRRT. Arterial blood gas analysis was conducted and serum cytokine levels, including tumor necrosis factor alpha (TNF-α), interleukin 4 (IL-4) and interleukin 6 (IL-6), as well as C reactive protein (CRP) were evaluated respectively both before and 6h, 12h, and 24h after CRRT therapy. Peak inspiratory pressure and pulmonary compliance were also recorded.

RESULTS: Arterial oxygen tension (PaO2), oxygenation index (OI) as well as dynamic pulmonary compliance were all elevated significantly, whereas peak inspiratory pressure significantly decreased at 6h, 12h and 24h after CRRT respectively; serum cytokine level and CRP significantly decreased (p < 0.05).

CONCLUSIONS: CRRT can effectively reduce the level of inflammatory mediators, and improve respiratory and circulatory function.

Free PDF Download