[Permanent venovenous hemofiltration in the complex therapy of severe acute pancreatitis]

Regardless of modern achievements in intensive therapy the mortality from severe acute pancreatitis progressed to a polyorganic insufficiency reaches 60%. Analysis of mortality structures shows that more than 50% of patients die from severe acute pancreatitis in first 72 hours, which is indicated as early severe pancreatitis. In the recent years the experimental and clinical studies proved that continuous vein to vein hemifiltration in the early stage allowes to lower the severity of poliorgan insufficiency and early death. The aim of the study was to measure the efficiency of vein to vein hemifiltration in the complex treatment of early severe acute pancreatitis. The retrospective analysis consisted of 106 patients, which were divided into 2 groups. 1st with vein to vein hemifiltration in the dose of less than 30ml/kg/h (n = 45) and more than 30 ml/kg/h (n = 20) respectively, the 3rd group did not receive vein to vein hemifiltration (n = 41). The study showed the decrease of early mortality (14 days) in the 2nd group (p = 0.022) and a tendency of decrease in the 2nd group (p = 0.093) compared to the 3rd group. The median interval from admission to death in the first two groups was 14 days while in the 3rd group it was only 5 days. The use of vein to vein hemifiltration in complex therapy of early severe acute pancreatitis patients allows to lower the early mortality. The best results were reached in the 2nd group.