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[Blood purification methods for treatment of organ failure in patients with severe pancreatitis]

G Pupelis1, E Austrums, K Snippe

  • 1Medical Academy of Latvia, Department of Surgery, Clinical Hospital "Gailezers", Riga, Latvia.

Zentralblatt Fur Chirurgie
|December 1, 2001
PubMed
Abstract

Insights

Extracorporeal blood purification methods, including hemadsorption, show promise in managing severe pancreatitis (SP) and multiple organ dysfunction syndrome (MODS). Early intervention may improve outcomes and can be combined with surgery.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Nephrology

Background:

  • Severe pancreatitis (SP) management has advanced, but extracorporeal blood purification's role in progressive multiple organ dysfunction syndrome (MODS) remains unclear.
  • Assessing the efficacy of extracorporeal blood purification methods in SP patients with MODS is crucial for improving treatment strategies.

Purpose of the Study:

  • To retrospectively evaluate the outcomes of MODS treatment using extracorporeal blood purification in patients with severe pancreatitis.
  • To analyze the impact of different blood purification techniques on mortality and organ involvement in SP patients.

Main Methods:

  • Retrospective analysis of 50 acute pancreatitis patients, with 45 meeting SP criteria based on the Atlanta classification.
  • MODS assessment using the 1991 Consensus Conference criteria, including organ system involvement and MODS score calculation.
  • Application of hemodialysis, hemofiltration, hemadsorption, and plasmapheresis in selected SP patients, often in conjunction with surgery.

Main Results:

  • MODS was observed in 34 SP patients, averaging 3.3-organ involvement.
  • Hemadsorption showed the lowest mortality rate (3.8%) among all SP patients treated.
  • Hemodialysis and hemofiltration in necrotizing pancreatitis patients were associated with a 20% mortality rate, while plasmapheresis had a 25% mortality rate.

Conclusions:

  • Combined renal and hepatic dysfunction significantly correlates with poor outcomes in severe pancreatitis.
  • Timely application of extracorporeal blood purification methods can potentially reverse MODS progression in SP patients.
  • Extracorporeal blood purification can be safely combined with surgical interventions when necessary for SP patients with MODS.

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