Xu J, et al. - In this study, early continuous veno-venous hemofiltration (CVVH) was tested for efficacy in decreasing the intra-abdominal pressure (IAP) and serum interleukin-8 (IL-8) level in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS). Findings demonstrated that CVVH effectively decreased IAP and the blood level of IL-8 in this patient population. Notably, a possible crucial role of IL-8 in the pathogenesis of ACS was suggested by the observed significant correlation between blood level of IL-8 and IAP. Overall, early CVVH appeared to be effective and was recommended to be applied in the early stage of ACS as it not only removed the causative cytokines such as IL-8 but also, thereby, decreased interstitial edema to lower IAP.

Methods

• Researchers performed a prospective study according to the standard management protocol, including 25 ACS patients of SAP.
• Patients were treated in the intensive care unit (ICU) of Affiliated Yidu Central Hospital of Weifang Medical College and underwent CVVH.
• Solely conventional treatment was given to 11 patients, set up as the control group, who received no hemofiltration and surgical treatment due to economic or other reasons.  
• Before and after treatment, serum amylase, liver and kidney function, and C reactive protein were investigated.
• Furthermore, researchers measured IAP and blood level of IL-8 daily to investigate their time course of changes and the correlation between the 2 parameters.

Results

• Findings demonstrated that serum amylase levels, C-reactive protein and IAP were significantly lower and liver and kidney function was significantly better, compared with those of the control group (p < 0.05).
• Data highlighted high IAP on admission to the ICU, at 22.9 ± 2.1 mm Hg.  
• Researchers found that 24 h after the initiation of CVVH, the IAP was significantly lower to 17.2 ± 2.2 mm Hg (p < 0.01), and thereafter decreased rapidly.
• It was also noted that the average blood level of IL-8 was high at 88.2 ± 25.1 ng/L on admission.
• However, results showed that it significantly decreased to 63.2 ± 18.7 ng/L (p < 0.01) 24 h after the initiation of CVVH, and subsequently decreased.
• In addition, a significant positive correlation between the blood level of IL-8 and IAP was observed (r = 0.62, p < 0.01).