Combination of Cytokine Hemosorption and High-volume Hemofiltration in Acute Pancreatitis
Acute Pancreatitis Without Necrosis or Infection
About this trial
This is an interventional treatment trial for Acute Pancreatitis Without Necrosis or Infection focused on measuring acute pancreatitis, sepsis, cytokines apsorbtion, hemoperfusion
Eligibility Criteria
Inclusion Criteria: Age from 18 to 75 years old, Acute pancreatitis according to the Atlanta classification of OP (2012), without signs of infection, Acute pancreatitis confirmed by tomography. Score according to the Modified CTSI Pancreatitis Severity Index: from 4 points and above, No more than 3 days from the onset of an attack of acute pancreatitis, APACHE II score - at least 10, The patient must receive adequate fluid therapy (at least 30 ml/kg) from the time of randomization until the first therapy, The patient's condition allows therapy for at least 4 hours. Exclusion Criteria: Age over 75, More than 3 days from the onset of an attack of acute pancreatitis, An attack of acute pancreatitis, as an exacerbation of chronic pancreatitis. Acute pancreatitis as a complication of a surgical operation, DS - Septic shock (Sepsis-3, 2016) The presence of a focus of non-sanitized surgical infection, Charlson comorbidity index> 5 points, Critical hypoxemia (PaO2/FiO2 < 150 mm Hg), GCS level of consciousness < 12 points, Obesity 3 degrees and above (weight over 150 kg), Blood triglyceride level >1000 mg/dl, (11.2 mmol/l), Dementia, Inability to achieve or maintain min SBP ≥ 65 mm Hg. Art., despite vasopressor therapy and infusion therapy in tech. 24 hours Presence of end-stage renal disease requiring RRT, The presence of cirrhosis of the liver (> 5 points according to the Child-Pugh classification), Unresolved biliary hypertension syndrome, Acute thromboembolism of the pulmonary artery, confirmed by tomography, Acute myocardial infarction within the last 4 weeks, Acute cerebrovascular accident, Transfusion reaction, Severe congestive heart failure, Uncontrolled bleeding (acute blood loss in the last 24 hours).
Sites / Locations
- V.P. Demikhov City Clinical Hospital No. 68Recruiting
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Baseline therapy
Basic therapy + Efferon CT + HVHF
Basic therapy - the routine practice of an institution for the treatment of patients with uninfected acute pancreatitis
Basic therapy, which is the routine practice of an institution for the treatment of patients with acute nonseptic pancreatitis in combination with extracorporeal hemoperfusion therapy (Efferon CT) and high-volume hemofiltration (HVHF).