AIM:To investigate the efficiency of continuous high volumehemofiltration (HVHF) in the treatment of severe acutepancreatitis (SAP) complicated with multiple organdysfunction syndrome (MODS).METHODS:A total of 28 SAP patients with an average of14.36±3.96 APACHE II score were involved.Diagnostic criteriafor SAP standardized by the Chinese Medical Associationand diagnostic criteria for MODS standardized by AmericanCollege of Chest Physicians (ACCP) and Society of CriticalCare Medicine (SCCM) were applied for inclusion.HVHF wasstarted 6.0±6.1 (1-30) days after onset of the disease andsustained for at least 72 hours,AN69 hemofilter (1.2 m~2)was changed every 24 hours.The ultrafiltration rate duringHVHF was 4 000 ml/h,blood flow rate was 250-300 ml/min,and the substitute fluid was infused with pre-dilution.Lowmolecular weight heparin was used for anticoagulation.RESULTS:HVHF was well tolerated in all the patients,andlasted for 4.04±3.99 (3-24) days.20 of the patients survived,6 patients died and 2 of the patients quited for financial reason.The ICU mortality was 21.4 %.Body temperature,heartrate and breath rate decreased significantly after HVHF.APACHE II score was 14.4±3.9 before HVHF,and 9.9±4.3after HVHF,which decreased significantly (P<0.01).Partialpressure of oxygen in arterial blood before HVHF was68.5±19.5 mmHg,and increased significantly after HVHF,which was 91.9±25 mmHg (P<0.01).During HVHF thehemodynamics was stable,and serum potassium,sodium,chlorine,glucose and pH were at normal level.CONCLUSION:HVHF is technically possible in SAP patientscomplicated with MODS.It does not appear to havedetrimental effects and may have beneficial effects.Continuous HVHF,which seldom disturbs the hemodynamicsand causes few side-effects,is expected to become abeneficial adjunct therapy for SAP complicated with MODS.
