The purpose of this study is to determine the effect and safety of early high-volume continuous veno-venous hemofiltration for patients with severe acute pancreatitis.
The investigators anticipated that early high-volume continuous veno-venous hemofiltration (EHVCVVH) would result in a decrease of the composite of persistent organ failure or death by eliminating inflammatory mediators in blood. This study is designed to evaluate the impact of EHVCVVH on patients with severe acute pancreatitis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
56
An AN69 hemofilter (1.6 m2 surface area, 35-KD limit; Baxter Healthcare Corp. Deerfield, IL, USA) will be used for EHCVVH.
Patients receive conventional treatments recommended by guidelines only.
Xijing Hospital of Digestive Diseases
Xi'an, Shaanxi, China
RECRUITINGpersistent organ failure or death
persistent organ failure: organ failure ≥ 48 hours
Time frame: 1 months
death
Time frame: 1 months
persistent organ failure
Time frame: 1 months
infectious complications
infected necrosis,bacteraemia and pneumonia respectively
Time frame: 1 months
input fluid volume within first 3 days after admission
crystalloid fluids and colloid fluids respectively
Time frame: 3 days
Physiological Parameters 1 day, 2 days, and 3 days after randomization
Physiological Parameters: APACHE-II score,SOFA score,Body temperature,PaO2/FiO2,BE,PLT,Cr,serum Ca,WBC and Urine volume
Time frame: 3 days
The concentration of inflammatory mediators in serum 0 hour,2 hours,6 hours and 12 hours after early high-volume continuous veno-venous hemofiltration
inflammatory mediators: tumor necrosis factor-α, IL-1, IL-2, IL-4, IL-6, and IL-8, IL-10, IL-13, IL-15, Angiopoietin-2, trypsin, resistin and visfatin
Time frame: 12 hours
total number of surgical interventions
for any purpose
Time frame: 2 months
ICU stay
Time frame: 2 months
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total costs in hospital
Time frame: 3 months
output fluid volume in the first, second, third day after admission
output: urine volume,ultrafiltration liquids,gastric drainage and defecation
Time frame: 3 days
persistent multiple organ dysfunction syndrome
multiple organ dysfunction syndrome (two or more organs or occurrence of two or more systemic complications at the same time) ≥ 48 hours
Time frame: 1 months
new-onset organ failure
not present at any time in the 24 hours before randomization
Time frame: 1 months
new-onset multiple organ dysfunction syndrome
Time frame: 1 months