Continuous blood purification for severe acute pancreatitis_… _ Medicine

Article Summary

Continuous blood purification for severe acute pancreatitis: A systematicreview and meta-analysis.

Hu Y, Xiong W, Li C, Cui Y.

Medicine (Baltimore). 2019 Mar;98(12):e14873. doi: 10.1097/MD.0000000000014873.

PMID: 30896634

Acute Pancreatitis can develop severe acute pancreatitis with persistent organ failure. To date, there is no specific drug in treating severe acute pancreatitis, and the treatment is still based on supportive care. This study is conducted to evaluate the efficacy of CBP in SAP treatment. CBP is performed to remove inflammatory cytokines and maintain the stability of the internal environment in the organism. It includes 4 RCTs and 8 prospective studies based on search for eligible studies from 1980 to 2018.

Result of the study shows that

• There is a significant advantage found in favor of the CBP approaches in terms of Acute Physiology and Chronic Health Evaluation II (APACHE II) score (WMD = −3.00,95%CI = −4.65 to −1.35)
• serum amylase (WMD = −237.14, 95% CI = −292.77 to 181.31)
• serum creatinine (WMD = −80.54,95%CI = 160.17 to −0.92)
• length of stay in the ICU (WMD = −7.15,95%CI = −9.88 to −4.43)
• mortality (OR = 0.60, 95%CI = 0.38–0.94).
• No differences were found in terms of CRP, ALT, and length of hospital stay

Conclusion:

• CBP improved clinical outcomes, including redced incidence organ failure, decreased serum amylase, APACHE II score, length in stay in the ICU and lower mortality rate. The study is concluding that it is a safer treatment option compared to conventional treatment.
• More higher quality RCTs will be needed to prove these findings

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