Abstract:
Objective To systematically evaluate the clinical efficacy of continuous veno-venous hemofiltration (CVVH) combined with hemoperfusion (HP) in treating hyperlipidemic acute pancreatitis (HLAP).
Methods The randomized controlled trials (RCTs) about CVVH combined with HP for treating patients with HLAP published up to December 2018 were searched from the Cochrane Library, PubMed, VIP, Wanfang and CNKI databases. Two reviewers independently screened articles, extracted data and evaluated quality according to the inclusion and exclusion criteria. Then meta-analysis was performed using the Review Manager 5.1 software.
Results Totally 10 RCTs with 687 patients were included, containing 343 patients in the experimental group (treated with CVVH and HP) and 344 patients in the control group (treated with CVVH). The meta-analysis suggested that the levels of serum triglyceride [mean difference (MD) = -7.37, 95% confidence interval (CI) (-10.54, -4.20), Z = 4.55, P < 0.000 01], in-hospital mortality [relative risk = 0.43, 95%CI (0.26, 0.71), Z = 3.32, P = 0.000 9], acute physiology and chronic health evaluation Ⅱ score [MD = -1.93, 95%CI (-2.63, -1.23), Z = 5.40, P < 0.000 01], serum tumor necrosis factor-alpha [MD = -67.21, 95%CI (-98.88, -35.54), Z = 4.16, P < 0.000 1] and serum interleukin-6 [MD = -50.60, 95%CI (-62.91, -38.28), Z = 8.05, P < 0.000 1] after treatment were significantly lower in the experimental group than in the control group.
Conclusion On the basis of conventional treatment, CVVH combined with HP is better than CVVH alone in treating HLAP.
Key words:
Acute pancreatitis,
Hyperlipidemias,
Hemofiltration,
Hemoperfusion,
Meta-analysis
Qiao Shi, Xiaoyi Zhang, Hanjun Li, Fang Jiang, Dongxue Xu, Xingcheng Xiong, Jia Yu, Weixing Wang, Jing Tao. Efficacy of continuous veno-venous hemofiltration combined with hemoperfusion in treating hyperlipidemic acute pancreatitis: a systematic review[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2020, 13(06): 439-445.