Abstract: To evaluate the effect of continuous veno-veno hemofiltraion (CVVH) on intra-abdominal pressure (IAP) in patients with severe acute pancreatitis and abdominal compartment syndrome. Methods A total of 54 patients admitted to the intensive care unit of our hospital due to severe acute pancreatitis and acute compartment syndrome in the period from 2003 to 2013 were enrolled in this study. They were divided into CVVH group (n=22) and control group (n=32). Patients in the CVVH group were additionally treated with CVVH after admitted to the ICU. Baxter portable continuous hemofiltration machine and AV600S hemofiltrator were used in the treatment. IAP, APACHE II score, sequential organ failure assessment (SOFA) score, oxygenation index (OI), mean arterial pressure (MAP), dopamine used (DA), and serum levels of creatinine (Scr), amylase (AMS), TNF-α, C-reactive protein (CRP) were assayed during the treatment. The days treated in ICU, the period on mechanical ventilation, and the 28-day mortality were compared between the two groups. Results ① After the treatment for 7, 14 and 28 days, IAP decreased significantly in CVVH group than in control group (P＜0.05); ② after the treatment for 3, 7 and 14 days, serum AMS was lower in CVVH group than in control group (P＜0.05); ③ after the treatment for 7 and 14 days, APACHE II score and SOFA score were lower in CVVH group than in control group (P＜0.05); ④ after the treatment for 3, 7 and 14 days, DA used and serum Scr were lower and MAP and OI were higher in CVVH group than in control group (P＜0.05); ⑤ after the treatment for 3, 7 and 14 days, serum TNF-α and CRP decreased more in CVVH group than in control group (P＜0.05); ⑥ the days treated in ICU and the period on mechanical ventilation were shorter in CVVH group than in control group, but the 28-day mortality was similar between the two groups. Conclusion CVVH effectively decreased APACHE Ⅱ score, SOFA score, and IAP level, with the reversal of organ dysfunctions in patients with acute compartment syndrome and severe acute pancreatitis. However, it did not change the 28-day-mortality significantly.

Key words: Continuous veno-veno hemofiltraion, Severe Acute Pancreatitis, Intra-abdominal hypertension, Acute compartment syndrome, cytokine