Table 4.

Blood purification modalities in patients with severe acute pancreatitis

First Author/CountryStudy Design (Year)No. of Patients with Acute PancreatitisBlood Purification ModalityOutcomes
Oda/Japan (40)Prospective observational (2005)17Continuous hemodiafiltrationIntra-abdominal pressure and IL-6 were significantly lower after 24 h of continuous hemodiafiltration initiation
Jiang/China (41)Randomized controlled (2005)37Low-volume versus high-volume CVVH, early versus late CVVHHigh-volume CVVH and early CVVH improved hemodynamics and survival in patients with acute pancreatitis more than low-volume CVVH and late CVVH
High-volume CVVH and early CVVH decreased serum concentrations of TNF-α, IL-1β, and IL-6 more efficiently than low-volume CVVH and late CVVH
Chen/China (42)Prospective observational (2007)20CVVHThe APACHE II score improved significantly after CVVH with improvement in endothelial dysfunction
Zhang/China (43)Randomized controlled (2010)63CVVH versus standard medical therapyCVVH improved APACHE II score and SOFA score significantly, and effectively improved gut barrier dysfunction
Gong/China (44)Prospective nonrandomized (2010)12High-volume CVVH versus standard medical therapyHigh-volume CVVH significantly reduced plasma inflammatory cytokines concentrations including those of IFN-γ, TNF-α, IL-1, IL-2, IL-5, and IL-13. Peripheral CD4+ and CD8+ T cells, monocyte count, and HLA-DR expression increased significantly only in the high-volume CVVH group
Yang/China (45)Randomized controlled (2010)51Combined CVVH and peritoneal dialysis versus traditional therapyInflammatory cytokines (IL-6, IL-8, and TNF-α) decreased significantly at days 1 and 2 compared with control group
The APACHE II score of the combined CVVH and peritoneal dialysis significantly decreased compared with the control group
Zhu/China (46)Prospective nonrandomized (2011)75High-volume CVVH versus conventional treatmentThe 28-d survival rate was higher in patients who accepted high-volume CVVH, especially in those without AKI. After 72 h of therapy, patients who accepted high-volume CVVH had significantly better APACHE II scores
Chu/China (47)Randomized controlled (2013)30Pulse high-volume hemofiltration versus CVVHThe levels of IL-6, IL-10, and TNF-α decreased in the pulse high-volume hemofiltration group more significantly than the control group
Pulse high-volume hemofiltration group was superior to the control group in APACHE II score, C-reactive protein, SOFA score, and SAPS II score
Guo/China (48)Prospective nonrandomized (2014)61High-volume CVVH versus optimal standard therapyHigh-volume CVVH was associated with a significant reduction in the incidence of kidney failure, infected pancreatic necrosis, length of hospitalization, mortality, as well as duration of kidney, respiratory, and hepatic failure
APACHE II score, C-reactive protein, and IL-6 levels were significantly reduced by high-volume CVVH on days 1, 3, and 7
Liu/China (49)Randomized controlled (2017)86High-volume CVVH versus CVVHThe levels of IL-4, IL-6, IL-8, and IL-10, as well as procalcitonin and TNF-α decreased in the high-volume CVVH group more than in the control group
Xu/China (50)Prospective nonrandomized (2017)25CVVH versus conventional treatmentCVVH more effective in decreasing intra-abdominal pressure and blood level of IL-8
  • CVVH, continuous venovenous hemofiltration; APACHE II, Acute Physiology and Chronic Health Evaluation II; SOFA, Sequential Organ Failure Assessment; SAPS II, Simplified Acute Physiology Score II.