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Impact of therapeutic plasmapheresis on the duration of organ failure in patients with hypertriglyceridemia-associated acute pancreatitis.

Authors :
Wang, Lanting
Zhou, Jing
Lv, Cheng
Hong, Donghuang
Wang, Zuozheng
Mao, Wenjian
Liu, Yuxiu
Zhang, Zixiong
Li, Yuanzhen
Li, Gang
Ye, Bo
Li, Baiqiang
Cao, Longxiang
Tong, Zhihui
Li, Weiqin
Ke, Lu
Yang, Qi
Lin, Jiajia
Gao, Lin
Chen, Yan
Source :
Annals of Intensive Care. 4/15/2024, Vol. 14 Issue 1, p1-8. 8p.
Publication Year :
2024

Abstract

Background: Plasmapheresis is widely used for severe hypertriglyceridemia-associated acute pancreatitis (HTG-AP) to remove excessive triglycerides from plasma. This study aimed to evaluate whether plasmapheresis could improve the duration of organ failure in HTG-AP patients. Methods: We analyzed a cohort of patients from a multicenter, prospective, long-running registry (the PERFORM) collecting HTG-AP patients admitted to the study sites within 72 h from the onset of symptoms. This study was based on data collected from November 2020 to March 2023. Patients who had organ failure at enrollment were involved in the analyses. The primary outcome was time to organ failure resolution within 14 days. Multivariable Cox regression model was used to evaluate the association between plasmapheresis and time to organ failure resolution. Directed acyclic graph (DAG) was used to identify potential confounders. Results: A total of 122 HTG-AP patients were included (median [IQR] sequential organ failure assessment (SOFA) score at enrollment, 3.00 [2.00–4.00]). Among the study patients, 46 underwent plasmapheresis, and 76 received medical treatment. The DAG revealed that baseline serum triglyceride, APACHE II score, respiratory failure, cardiovascular failure, and renal failure were potential confounders. After adjusting for the selected confounders, there was no significant difference in time to organ failure resolution between patients undergoing plasmapheresis and those receiving exclusive medical treatment (HR = 1.07; 95%CI 0.68–1.68; P = 0.777). Moreover, the use of plasmapheresis was associated with higher ICU requirements (97.8% [45/46] vs. 65.8% [50/76]; OR, 19.33; 95%CI 2.20 to 169.81; P = 0.008). Conclusions: In HTG-AP patients with early organ failure, plasmapheresis was not associated with accelerated organ failure resolution compared to medical treatment but may be associated with more ICU admissions. Trial registration: The PERFORM study was registered in the Chinese Clinical Trial Registry (ChiCTR2000039541). Registered 30 October 2020. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
21105820
Volume :
14
Issue :
1
Database :
Academic Search Index
Journal :
Annals of Intensive Care
Publication Type :
Academic Journal
Accession number :
176610052
Full Text :
https://doi.org/10.1186/s13613-024-01285-3