Timing of blood purification therapy in acute pancreatitis with systemic inflammatory response syndrome

"Objective To explore the timing of blood purification (BP) therapy in patients with acute pancreatitis (AP) who develop systemic inflammatory response syndrome (SIRS). Methods A retrospective collection was made of 254 AP patients with SIRS who underwent BP treatment at the Affiliated Baiyun Hospital of Guizhou Medical University from May 2015 to May 2023, and at the Affiliated Hospital of Guizhou Medical University from September 2021 to April 2023. Patients were divided into Group A (＜6 h,n=62), Group B (6-12 h,n=52), Group C (＜12-24 h,n=52), and Group D (＞24 h,n=88) based on the time from SIRS onset to BP treatment. Mortality rate, rate of patient's request for discharge, local complications, systemic complications, ICU transfer, mechanical ventilation, hospital stay, and treatment costs were used as prognostic indicators to study the impact of different BP treatment times on these indicators. Results The incidences of acute peripancreatic fluid collection and renal failure in Groups C and D were significantly higher than those in Group A (P＜0.05); the incidences of circulatory failure and mechanical ventilation in Group D were significantly higher than those in Group A (P＜0.05); the incidence of coagulation dysfunction in Groups C and D was significantly higher than that in Groups A and B (P＜0.05); the incidence of patients transferred to ICU in Groups B, C, and D was higher than that in Group A (P＜0.05); the hospital stay and treatment costs for patients in Group D were significantly higher than those in Groups A, B, and C (P＜0.05). Conclusion BP treatment within 6 hours of diagnosing SIRS can reduce the incidence of patient transfer to ICU; BP treatment within 12 hours can reduce the incidence of pancreatic exudate, renal failure, and coagulation dysfunction; BP treatment within 24 hours can reduce the incidence of circulatory failure and mechanical ventilation, as well as decrease hospital stay and treatment costs."