Early renal replacement therapy and respiratory status in patients with acute severe pancreatitis

The use of renal replacement therapy (RRT) in the complex intensive care of acute severe pancreatitis (ASP) for extrarenal indications is important for the protection of target organs, but at the moment there are no unified approaches to its implementation.

Objectives: to study the effect of complex intensive therapy with early inclusion of RRT on respiratory status indicators in patients with ASP.

Methods. Respiratory status indicators were analyzed in 72 patients with ASP, divided into 2 groups depending on the fact of early RRT (from the second day of hospitalization).

Results. Conducting complex intensive therapy with the inclusion of early RRT in patients with ASP normalized the parameters of the gas composition of arterial blood, manifested by an increase in the respiratory index, pO₂, a decrease in lactate levels, and an increase in respiratory compliance. Moreover, extrarenal indications for inclusion in complex intensive therapy of early RRT in patients with ASP include the following: low respiratory index (≤ 177 mmHg), respiratory compliance (≤ 33 ml/cm H₂O), pO₂ (≤ 85 mmHg) and hyperlactatemia (≥ 2.5 mmol/l).

Conclusion. The first experience of complex intensive care with the inclusion of early (from the second day of hospitalization) RRT showed its positive effect on respiratory status in patients with ASP with a decrease in mortality from 52 % to 35 %.

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