November 12, 2014
Notes: Wu, Lili
Digestion. 2013;88(2):128-34. doi: 10.1159/000353597. Epub 2013 Sep 4.
Author Address: Department of Gastroenterology and Hepatology, The Chinese People’s Liberation Army General Hospital, Beijing, China.
Reference Type: Journal Article
Record Number: 5028Author: Xu, J., Tian, X., Zhang, C., Wang, M. and Li, Y.
Title: Management of abdominal compartment syndrome in severe acute pancreatitis patients with early continuous veno-venous hemofiltration
Short Title: Management of abdominal compartment syndrome in severe acute pancreatitis patients with early continuous veno-venous hemofiltration
Alternate Journal: Hepato-gastroenterology
ISSN: 0172-6390 (Print)
Accession Number: 23933789
Keywords: Acute Disease
Analysis of Variance
Severity of Illness Index
Tumor Necrosis Factor-alpha/blood
Abstract: BACKGROUND/AIMS: The present study investigates whether early continuous veno-venous hemofiltration (CVVH) is effective for decreasing intra-abdominal pressure (IAP) and serum TNF-alpha in abdominal compartment syndrome (ACS) patients of severe acute pancreatitis (SAP), and to study the correlation between IAP and serum TNF-alpha level. METHODOLOGY: Twenty-five ACS patients of SAP were treated in the ICU and underwent CVVH. IAP and blood level of TNF-alpha were measured daily to investigate their time-course of changes and the correlation between the two parameters. RESULTS: IAP on admission to the ICU was high (22.9+/-2.1 mmHg). The IAP was significantly lower (17.2+/-2.2 mmHg; p <0.01) 24 h after initiation of CVVH, and thereafter decreased rapidly. Mean the blood level of TNF-alpha was high (59.9+/-18.2 ng/L) on admission. However, it significantly decreased (41.1+/-12.8 ng/L; p <0.01) 24 h after initiation of CVVH, and subsequently decreased. There was a significant positive correlation between blood level of TNF-alpha and IAP (r = 0.53, p <0.01). CONCLUSIONS: CVVH significantly decreased IAP and TNF-alpha in ACS patients of SAP. TNF-alpha was significantly correlated with IAP, suggesting that TNF-alpha may play an important role in the pathogenesis of ACS. Early CVVH can improve vascular permeability through elimination of cytokines such as TNF-alpha, and thereby decrease interstitial edema to lower IAP and should be applied in the early stages of ACS.