Original Article
Effect of plasma exchange combined with continuous renal replacement therapy in patients with severe acute pancreatitis
Peipei Xie, Fuguo Yang, Xinting Pan, Chenglin Zhang, Jingyu Song
Published 2019-10-01
Cite as Chin J Crit Care Med(Electronic Edition), 2019, 12(5): 301-305. DOI: 10.3877/cma.j.issn.1674-6880.2019.05.003
Abstract
ObjectiveTo investigate the effect of early plasma exchange combined with continuous renal replacement therapy (CRRT) in the treatment of patients with severe acute pancreatitis (SAP).
MethodsA total of 135 SAP patients admitted to the ICU and Emergency ICU of Affiliated Hospital of Qingdao University between March 2016 and September 2018 were randomly divided into the routine group (69 cases) and plasma exchange group (66 cases) according to their hospital numbers. Patients in the routine group were treated with CRRT immediately after admission for 72 h, and patients in the plasma exchange group were treated with plasma exchange and CRRT for 72 h. The therapeutic effect, hospitalization time, serological indicators, incidence of complications, and average filter life were compared between the two groups.
ResultsThe therapeutic effect was significantly better in the plasma exchange group than in the routine group [87.88% (58/66) vs. 65.22% (45/69), χ2= 9.579, P= 0.002]. The hospitalization time was significantly shorter in the plasma exchange group than in the routine group [(11.4 ± 1.5) d vs. (21.3 ± 2.8) d, t= 2.979, P= 0.004]. The levels of serum amylase [(103 ± 24) U/L vs. (267 ± 60) U/L, t= 2.419, P= 0.021], C-reactive protein [(51 ± 8) mg/L vs. (129 ± 19) mg/L, t= 4.574, P < 0.001] and white blood cell [(8.9 ± 0.5) × 109/L vs. (11.5 ± 1.0) × 109/L, t= 2.059, P= 0.046] after treatment and the incidence of acute respiratory distress syndrome [6.06% (4/66) vs. 34.78% (24/69), χ2= 16.930, P < 0.001], multiple organ dysfunction syndrome [7.58% (5/66) vs. 30.43% (21/69), χ2= 11.340, P < 0.001] and pancreatic encephalopathy [9.09% (6/66) vs. 39.13% (27/69), χ2= 16.480, P= 0.002] in the plasma exchange group were significantly lower than those in the routine group. The average filter life of the plasma exchange group was significantly longer than that of the routine group [(24.7 ± 2.3) h vs. (12.1 ± 1.4) h, t= 4.829, P < 0.001].
ConclusionsPlasma exchange combined with CRRT is effective in the treatment of SAP and worthy of clinical application. It can significantly improve patients' clinical symptoms and serum test results, reduce the incidence of complications and prolong the filter life, thereby improving the quality of extracorporeal circulation therapy.
Key words:
Severe acute pancreatitis; Plasma Exchange; Continuous renal replacement therapy
Contributor Information
Peipei Xie
Department of Emergency Internal Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Fuguo Yang
Qingdao University School of Nursing, Qingdao 266071, China
Xinting Pan
Department of Emergency Intensive Care Unit, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Chenglin Zhang
Department of Transplantation Care Unit, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Jingyu Song
Department of Emergency Intensive Care Unit, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
