The role of continuous blood purification therapy in severe acute pancreatitis

Abstract

We report our study of continuous blood purification therapy (CBP) carried out for the purpose of fluid management in severe acute pancreatitis (SAP). We retrospectively examined 28 cases of SAP treated with CBP in our institution between April 1, 2005 and April 1, 2012. A comparison of the survivor and non-survivor groups shows that there was no significant difference in the pancreatitis disease severity score; however, the average APACHE Ⅱ score for time of onset of CBP and SOFA score were significantly higher in the non-survivor group. Among the survivors, despite early large-dose transfusions, central venous pressure and PaO₂/F_IO₂ ratio were maintained appropriately throughout, with no aggravation of respiratory status or overhydration. In the non-survivors, central venous pressure rose and gradually became in-over, so that the maintenance of blood pressure became difficult, and the volume of fluid drained was small. In treatment of the SAP, CBP is an important treatment modality for fluid management to control water and solutes or electrolytes.