Clearance effects of high volume continuous venoª²venous hemofiltration on cytokines in patients with severe acute pancreatitis

    LI Zhenª²Jiang, CHEN Wei, XU Yueª²Qing, WANG Hanª²Min

    Department of Renal Diseases, Xijing Hospital, Fourth Military Medical University, Xi¡¯an 710033, China

    ¡¾Abstract¡¿ AIM: To investigate the role of high volume continuous venoª²veous hemofiltration (HVª²CVVH) in the cytokines removal in patients with severe acute pancreatitis. METHODS: Thirteen severe acute pancreatitis patients who had renal failure and the APACHE III scores of 23¡À5 were treated with continuous venoª²venous hemofiltration (CVVH) and were divided into two groups according to the different substitution rates: Group I (2 L/h, n=8) and group II (4 L/h, n=5). The blood samples, drawn from the postfilter at 0, 1, 2, 3, 6, 24 h, were immediately centrifuged. Cytokines (TNFª²¦Á, ILª²6 and ILª²10) in serum were analyzed with ELISA. RESULTS: The levels of all cytokines declined quickly 3 h after CVVH, which was more significant in group II. Three hours after CVVH, the serum levels of TNFª²¦Á and ILª²10 declined slowly. The hemodynamics of patients was stable. APACHE III scores showed that the conditions of patients in group II were improved significantly after CVVH. CONCLUSION: HVª²CVVH is very effective in cytokine removal in severe acute pancreatitis patients with renal failure and can maintain stable hemodynamic parameters, which may help alleviate the symptoms of patients. ......