ABSTRACT
Objective To compare the therapeutic effects of continuous veno-venous hemofiltration (CVVH) versus repeated intermittent veno-venous hemofiltration (RIVVH) on patients with severe acute pancreatitis (SAP).Methods Fifty-six patients with SAP were randomly divided into the CVVH group (n =28) and the RIVVH group (n =28).The clinical symptoms and signs,the APACHE Ⅱ and MODS scores,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL-6,IL8 before and after treatment,the duration of mechanical ventilation,boosting drug application time,the length of stay in ICU,the surgical intervention rate and the mortality were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment (P ＜ 0.05).The APACHE Ⅱ and MODS scores were all reduced in the two groups after treatment (P ＜ 0.05).When compared with the RIVVH group,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL6,IL-8 were significantly decreased (P ＜ 0.05).The duration of mechanical ventilation,the length of stay in ICU and the mortality were also significantly decreased in the CVVH group (P ＜ 0.05).Conclusions CVVH was more efficacious than RIVVH in the treatment of SAP.
ABSTRACT
Objective To compare the effects of continuous veno-venous hemofiltration (CVVH) and intermittent hemofiltration (IHF) on the hemodynamics and clinical outcomes of patients with type 1 cardiorenal syndrome. Methods From May 2008 to June 2011, 34 patients diagnosed with type 1 cardiorenal syndrome were admitted to our hospital and received CVVHQ9 cases) or IHF (15 cases). The general data, acute hemodynamic changes before and after hemofiltration and clinical outcomes at 28 days after hemofiltration were evaluated. Results There were no significant differences in the heart rates, diastolic blood pressure between the two groups before and after hemofiltration (P>0.05). The systolic pressure was similar between the two groups before hemofiltration (P>0.05), but that in the IHF group was significantly lower than that in the CVVH group after hemofiltration (P0.05), but the minimal mean pressure in IHF group was significantly lower than that in the CVVH group (P0.05). Multivariate analysis suggested that APACHE II was the main influence factor of 28-day mortality of patients, and APACHE II and net ultrafiltration were the main influence factor of the minimal mean pressure. Conclusion Compared with IHF, CVVH fails to greatly reduce the mortality of patients with type 1 cardiorenal syndrome. The severity of the disease is the main influence factor for the hemodynamic changes and the 28-day mortality of patients with type 1 cardiorenal syndrome.