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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2024

Open Access 01-12-2024 | Acute Pancreatitis | Research

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

Authors: Lanting Wang, Jing Zhou, Cheng Lv, Donghuang Hong, Zuozheng Wang, Wenjian Mao, Yuxiu Liu, Zixiong Zhang, Yuanzhen Li, Gang Li, Bo Ye, Baiqiang Li, Longxiang Cao, Zhihui Tong, Weiqin Li, Lu Ke, for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)

Published in: Annals of Intensive Care | Issue 1/2024

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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.
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Metadata
Title
Impact of therapeutic plasmapheresis on the duration of organ failure in patients with hypertriglyceridemia-associated acute pancreatitis
Authors
Lanting Wang
Jing Zhou
Cheng Lv
Donghuang Hong
Zuozheng Wang
Wenjian Mao
Yuxiu Liu
Zixiong Zhang
Yuanzhen Li
Gang Li
Bo Ye
Baiqiang Li
Longxiang Cao
Zhihui Tong
Weiqin Li
Lu Ke
for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)
Publication date
01-12-2024
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2024
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-024-01285-3

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