Acute Pancreatitis
Conditions
Keywords
Systemic Inflammatory Response Syndrome, Continuous Blood Purification
Brief summary
Systemic Inflammatory response syndrome(SIRS) is common in patients with severe acute pancreatitis (SAP) in early stage. Continuous Blood Purification (CBP), especially Continuous Veno-Venous Hemofiltration(CVVH) is proved to have an important role in SAP patients to control SIRS. But the detail treatment for this is controversial. In this study, the investigators aim to evaluate the different effects of three kinds of treatment protocols which is CVVH 6h,continuous venovenous hemodiafiltration(CVVHDF) 6h,CVVH 10h for first three days in SAP patients. Compare the vital sign, SIRS parameters, and others between these three groups. This study will try to find a better way for CBP in patients with SAP
Detailed description
Condition Severe Acute Pancreatitis Intervention CVVH 6 hours for first three days CVVH 10 hours for first three days CVVHDF 6 hours for first three days All therapeutic volume is 45ml/kg.h, Device: Braxter HF 1200
Interventions
OTHERCVVH 6h
CVVH 6h for first three days
OTHERCVVH 10h
CVVH 10h for first three days
OTHERCVVHDF 6h
CVVHDF 6h for first three days
Sponsors
RenJi Hospital
Ruijin Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria: 1. Diagnosis of pancreatitis: * Typical pain * Increase in serum lipase or amylase * Onset of abdominal pain within \<=72h before admission 2. The diagnosis criteria of Severe Acute Pancreatitis is according to Atlanta criteria revisited in 2012 3. no chronic diseases such as Chronic Obstructive Pulmonary Disease, Diabetes Mellitus and so on 4. Age from 18 to 65 years old Besides criteria above, the patient should also satisfied one of these CBP criteria: 1. Have Acute Kidney Injury satisfied RIFLE classification (risk above): increased Serum Creatinine \> 1.5 times baseline，26.5umol/L increase, or urine output \< 0.5ml/kg.h for 6 hours 2. Systemic Inflammatory Response Syndrome: temperature \>38℃ or\<36℃；heart rate respiratory rate White blood cell count \>12\*10\^9/L，or\< 4\*10\^9/L 3. Refractory acid-base and electrocyte balance disorder, metabolic acidosis conservative treatment is not effective.
Exclusion criteria
1. Pregnancy 2. Chronic pancreatitis 3. Immunosuppression condition such as HIV, Corticosteroid for 3 weeks in 60 days; White Blood Cell \< 0.5\*10\^9/L for 10 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Efficiency of CBP with Inflammatory Response | 3 days | Efficiency of CBP with inflammatory response was assessed by the following measurements: 1. Inflammatory mediators removal:tumor necrosis factor-α, interleukin(IL-1, IL-2, IL-6, and IL-8, IL-10, sIL-2R)before and after CBP in first three days 2. SIRS parameters variation: (Heart rate, respiratory rate, White Blood Cell, Temperature, C response protein) before and after CBP in first three days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mortality | 28 days | Mortality of 28 days |
| operation time | 28 days | operation time of 28 days |
| local complication of severe acute pancreatitis | 28 days | local complication of SAP in 28 days |
Other
| Measure | Time frame |
|---|---|
| ICU and hospital duration | participants will be followed for the duration of hospital stay, an expected average of 8 weeks |
Countries
China
Outcome results
None listed