Methods of extracorporeal detoxification in the treatment of patients with acute necrotic pancreatitis and DIC

Abstract

The article analyzes the results of treatment of patients with acute necrotic pancreatitis and DIC who underwent extracorporeal detoxification (ECD) with heparin anticoagulation. We performed a retrospective analysis of the medical records of such patients who were treated in Moscow Clinical Hospital No. 24 in 2016–2017. Disorders indicating the development of DIC were detected in 38 patients with acute necrotic pancreatitis, 13 of them underwent extracorporeal detoxification methods, in 25 patients ECD was not used. The effect of ECD on hemostasis and clinical outcomes was studied. A tendency towards the progression of coagulopathy and an increase in the risks of developing hemorrhagic syndrome, multiple organ failure and death during extracorporeal detoxification with heparin anticoagulation was revealed. The insufficiently large number of patients included in the study does not allow us to draw a final conclusion about the use of heparin anticoagulation ECD in patients with acute destructive pancreatitis who were initially showing the signs of consumption coagulopathy, but the data obtained cast a doubt on its feasibility. Further research is needed to make recommendations for the use of ECD in this category of patients.