HIỆU QUẢ THAY HUYẾT TƯƠNG Ở BỆNH NHÂN VIÊM TỤY CẤP DO TĂNG TRIGLYCERIDE MÁU TẠI KHOA ICU BỆNH VIỆN ĐA KHOA TRUNG TÂM AN GIANG

Abstract

Background: Hypertriglyceridemia is the third most common cause of acute pancreatitis. Plasma exchange is an effective treatment for reducing blood triglycerides rapidly. Objectives: To assess plasma exchange's effectiveness in treating hypertriglyceridemic acute pancreatitis. Materials and methods: The patients were diagnosed with acute pancreatitis due to hypertriglyceridemia. The study describes a series of cases, triglyceridemia levels before and after plasma exchange were compared. SOFA, Ranson, and BISAP scores were performed upon ICU admission and after plasmapheresis. Results: From 2021 to 2022, there were 20 patients, 85% men, 15% women; Average age 38.90 ± 6.7 years old. Triglycerides decreased from 20.36 ± 15.99mmol/L to 5.59 ± 2.71 mmol/L during the first plasma exchange and to 2.71 ± 1.77 mmol/L after the second plasma exchange (p <0.001). The average ICU stay was 4 ± 2.2 days. A hospital death was not reported. SOFA score decreased significantly from 7 ± 1.5 points at admission to 2.29 ± 0.8 points at the time of transferring the patient out of the ICU (p<0.001). BISAP score at admission was 3.15 ± 0.9 points and 2.9 ± 0.8 points at the time of transferring the patient out of the ICU (p <0.001).

Ranson criteria were 3.15 ± 0.7 points on admission and 1.8 ± 0.6 at the time of transferring the patient out of the ICU (p <0.001). Conclusion: The treatment of acute hypertriglyceridemia-induced pancreatitis with plasma exchange is safe, effective, and fast. Concurrently this method also significantly improves the clinical outcomes of patients.