Influence of continuous renal replacement therapy combined with hemoperfusion on the pulmonary function and prognosis of patients with severe acute pancreatitis

Abstract

Objective To study the influence of continuous renal replacement therapy (CRRT) combined with hemoperfusion(HP) on the pulmonary function and prognosis of patients with severe acute pancreatitis(SAP). Methods 62 patients were chosen as study objects, and they were divided into CRRT group (31 cases) and CRRT+ HP group(31 cases) according to the digital table.After treatment, the incidence rate of acute liver injury(ALI)/ acute respiratory distress syndrome(ARDS), mortality, PaO2, PaO2/FiO2, tumor necrosis factor α(TNF-α) and IL-18 levels were compared. Results The incidence rate of ALI/ARDS and mortality in the CRRT+ HP group were 22.58%(7/31) and 6.45%(2/31), respectively, which in the CRRT group were 51.61%(16/31), 25.81%(8/31), respectively, the differences between the two groups were statistically significant(χ2=5.599, 4.292, all P<0.05). After treatment, the PaO2 and PaO2/FiO2 of the CRRT+ HP group were (85.9±7.6)mmHg and (245.8±35.6)mmHg, respectively, which were higher than those of the CRRT group [(69.8±9.4)mmHg, (198.6±31.2)mmHg] (t=5.912, 5.314, all P<0.05). The TNF-α and IL-18 levels of the CRRT+ HP group were (11.95±0.67)ng/L and (325.87±84.17)ng/L, respectively, which were lower than those of the CRRT group [(17.32±0.54)ng/L, (441.08±72.97)ng/L], and the differences were statistically significant(t=5.174, 6.771, all P<0.05). Conclusion CRRT combined with HP can alleviate pulmonary function and prognosis of patients with SAP. Key words: Renal replacement therapy; Hemoperfusion; Pancreatitis, acute necrotizing; Respiratory function tests; Prognosis