Continuous Veno-venous Hemofiltration for Patients with Hyperlipidemic Pancreatitis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 HUANGHui-bin ¹ , ZHENGWen-he ² , LIYing ¹ ,  LINJian-dong ¹

1. Department of Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou 350000, China;
2. Department of Critical Care Medicine, People's Hospital of Fujian Traditional Medical University, Fuzhou 350000, China;

Corresponding author：

LINJian-dong, Email: linjd1680067@sina.com

Keywords：

Continuous veno-venous hemofiltration; Hyperlipidemic pancreatitis; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140101

Video：

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Objective To systematically review the effect and safety of continuous veno-venous hemofiltration (CVVH) on patients with hyperlipidemic pancreatitis. Methods Databases including the Cochrane Library (Issue 2, 2014), PubMed, EMbase, CBM, CNKI and WanFang Data were electronically searched for randomized controlled trials (RCTs) about CVVH on patients with hyperlipidemic pancreatitis till Feb. 12, 2014. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 7 trials met eligibility criteria, involving 360 cases, including 183 cases of CVVH group and 177 cases of control group. The results of meta-analysis showed that compared with only routine medical treatment, CVVH significantly reduced the levels of lipid (WMD=-4.63, 95%CI-5.98 to-3.27, P < 0.000 01), levels of IL-6 (WMD=-29.59, 95%CI-34.30 to-24.89, P < 0.000 01), overall mortality (RR=0.39, 95%CI 0.18 to 0.84, P=0.02), and APACHE II score (WMD=-3.34, 95%CI-5.12 to-1.56, P=0.000 2) after treatment. Conclusion CVVH is more effective for hyperlipidemic pancreatitis than only routine medical treatment. Due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are required to verify the above conclusion.

Citation： HUANGHui-bin, ZHENGWen-he, LIYing, LINJian-dong. Continuous Veno-venous Hemofiltration for Patients with Hyperlipidemic Pancreatitis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(5): 611-617. doi: 10.7507/1672-2531.20140101 Copy

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12.	钱明江, 高飞, 陈淼, 等.血液灌流联合CVVH治疗高脂血症性重症急性胰腺炎的临床观察.中国医药科学, 2013, 3(18):16-18.
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18.	季大玺, 龚德华, 徐斌, 等.连续性血液净化在重症监护病房中的应用.中华医学杂志, 2002, 82(18):1292-1294.
19.	毛恩强, 汤耀卿, 韩天权, 等.短时血滤对重症急性胰腺炎治疗的影响.中华外科杂志, 1999, 37(3):141-143.
20.	Mao EQ, Tang YQ, et al. Formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis. World J Gastroenterolo, 2003, 9(11):2622.
21.	中华医学会消化病分会胰腺病学组.中国急性胰腺炎诊治指南(草案).中华消化杂志, 2004, 24:190-192.
22.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehandbook.org.
23.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414):557-560.
24.	Wang XP, Zheng Y. Advancement in research on the heperlipidemia with etiopathogenesis of pancreatitis. Inte J Dig Dis, 2006, 26(4): 219-220.
25.	Strate T, Mann O, Kleinhans H, et al. Systemic intravenous infusion of bovine hemoglobin significantly reduces microcirculatory dysfunction in experimentally induced pancreatitis in the rat. Ann Surg, 2003, 238(5):765-771.
26.	杨朝晖, 杨摇军, 汪勇俊.连续性血液滤过对重症急性胰腺炎诱发组织器官损害的保护作用.中国危重病急救医学, 2004, 16(4): 232.
27.	李振江, 陈威, 徐月清, 等.重症急性胰腺炎患者HV-CVVH清除细胞因子的作用.第四军医大学学报, 2004, 25(9):846-848.
28.	杨春娥.连续静脉-静脉血液滤过治疗中并发症的预防.中国实用护理杂志, 2004, 20(2):12-14.

1. Yadav D, Pitchumoni CS. Issues in hyperlipidemic pancreatitis. J Clin Gastroenterol, 2003, 36:54-62.
2. Ewald N, Hardt PD, Kloer HU. Severe hypertriglyceridemia and pancreatitis:presentation and management. Curr Opin Lipidol, 2009, 20(6):497-504.
3. Durval A, Zamidei L, Bettocchi D, et al. Hyperlipidemic acute pancreatitis:a possible role of antiretroviral therapy with entecavir. Minerva Anestesiol, 2011, 77(10):1018-1021.
4. 于浩, 邹忠东, 王烈.高脂血症性胰腺炎的诊治进展.医学综述, 2010, 16(16):2449-2451.
5. 中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南草案.中华内科杂志, 2004, 43(3):236-238.
6. Kadikoylu G, Yavasoglu I, Bolaman Z. Plasma exchange in severe hypertriglyceridemia a clinical study. Transfus Apher Sci, 2006, 34(3):253-257.
7. Stefanutti C, Labbadia G, Morozzi C. Severe hypertriglyceridemiarelated acute pancreatitis. Ther Apher Dial, 2013, 17(2):130-137.
8. Bajpai M, Tyagi P, Maharshi S. Therapeutic plasma exchange in hyperlipidemic pancreatitis. Transfusion, 2012, 52(5):929.
9. Chen JH, Yeh JH, Lai HW, et al. Therapeutic plasma exchange in patients with hyperlipidemic pancreatitis. World J Gastroenterol, 2004, 10(15):2272-2274.
10. Zhang G, Feng J, Xu QP, et al. Double filtration plasmapheresis in treatment of hyperlipidemic acute pancreatitis. Journal of Zhejiang University. Medical sciences, 2008, 37(1):93-96.
11. 邵伟, 赵二鹏, 傅强, 等.血液净化对重症急性胰腺炎伴重度高脂血症的作用.中国中西医结合外科杂志, 2009, (5):509-511.
12. 钱明江, 高飞, 陈淼, 等.血液灌流联合CVVH治疗高脂血症性重症急性胰腺炎的临床观察.中国医药科学, 2013, 3(18):16-18.
13. 周秀华.血液灌流联合连续肾脏替代治疗高脂血症性重症胰腺炎的研究.山西医药杂志, 2012, 41(12):1282-1283.
14. 黄鹏, 王春友, 吴河水, 等.持续血液滤过治疗高脂血症性急性胰腺炎24例.世界华人消化杂志, 2012, 20(11):964-968.
15. 何文华, 刘王, 朱勇.高甘油三脂血症性胰腺炎的紧急降脂治疗:比较早期高容量血液滤过与低分子肝素联合胰岛素的单中心, 前瞻性, 随机对照研究初步结果. 2012中国消化病学大会:190.
16. 钟世洪, 辛志军.低分子肝素联合床旁持续血液滤过应用于高脂血症性胰腺炎的效果分析.健康必读, 2012, (4):26.
17. 戴晓荣, 成宏伟, 陈永康, 等.早期血液净化对重症急性胰腺炎伴重度高脂血症的疗效分析.中外医疗, 2012, 31(35):87-89.
18. 季大玺, 龚德华, 徐斌, 等.连续性血液净化在重症监护病房中的应用.中华医学杂志, 2002, 82(18):1292-1294.
19. 毛恩强, 汤耀卿, 韩天权, 等.短时血滤对重症急性胰腺炎治疗的影响.中华外科杂志, 1999, 37(3):141-143.
20. Mao EQ, Tang YQ, et al. Formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis. World J Gastroenterolo, 2003, 9(11):2622.
21. 中华医学会消化病分会胰腺病学组.中国急性胰腺炎诊治指南(草案).中华消化杂志, 2004, 24:190-192.
22. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehandbook.org.
23. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414):557-560.
24. Wang XP, Zheng Y. Advancement in research on the heperlipidemia with etiopathogenesis of pancreatitis. Inte J Dig Dis, 2006, 26(4): 219-220.
25. Strate T, Mann O, Kleinhans H, et al. Systemic intravenous infusion of bovine hemoglobin significantly reduces microcirculatory dysfunction in experimentally induced pancreatitis in the rat. Ann Surg, 2003, 238(5):765-771.
26. 杨朝晖, 杨摇军, 汪勇俊.连续性血液滤过对重症急性胰腺炎诱发组织器官损害的保护作用.中国危重病急救医学, 2004, 16(4): 232.
27. 李振江, 陈威, 徐月清, 等.重症急性胰腺炎患者HV-CVVH清除细胞因子的作用.第四军医大学学报, 2004, 25(9):846-848.
28. 杨春娥.连续静脉-静脉血液滤过治疗中并发症的预防.中国实用护理杂志, 2004, 20(2):12-14.

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Continuous Veno-venous Hemofiltration for Patients with Hyperlipidemic Pancreatitis: A Systematic Review

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