Hata T, Akiba T, Haneda M, Noda Y, Adachi M, Matsumura Y, Tachibana K, Matsuda O, Marumo F
CPD using closed-system automated PD is effective in the treatment of severe acute pancreatitis
17th Annual CAPD Conference
Perit Dial Int Suppl 1 (Feb) 17:S95 1997

A number of anecdotal reports and small series have been contributed in an effort the support the use of PD to clear substances (cytokines?, "evil humors"?) associated with pancreatitis. Concern has been voiced about the introduction or aggravation of infections that may offset any therapeutic benefit. This abstract describes the prospective experience with 7 patients (mean Ranson’s criteria score 4.7 out of 11) treated with closed system automated PD from 9-34 days (average 16). Only one patient died (of respiratory failure) representing an extremely low mortality rate (14.2%) compared to 18 historical reports (not identified in abstract). Ranson’s criteria alone would suggest greater than 40% mortality.

Comment: A disease process as complex as severe pancreatitis demands control of a number of confounding variables. Rapid advances in critical care medicine make historical controls less relevant. This report failed to define the incidence of PD associated infection or other morbidity. The use of dialysis for this non-dialytic indication remains experimental. (Sri Narsipur, MD, SUNY-HSC at Syracuse, NY)

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17th Annual CAPD Conference
CRF by organ system : GI/Liver, Hepatitis