Effect of blood purification combined with antibiotics on CC-16 and SP-D levels and prognosis in patients with severe acute pancreatitis complicated by acute respiratory distress syndrome.

Summary

In 128 SAP-ARDS patients, adding continuous blood purification to standard care plus antibiotics yielded shorter edema resolution and ventilator weaning times, reduced hospital stay, improved respiratory mechanics and oxygenation, and lower 28-day mortality. CC-16 and SP-D levels decreased more in the CBP group, aligning with attenuated lung injury.

Key Findings

• CBP plus antibiotics reduced pancreatic edema resolution time, ventilator weaning time, and hospital stay versus routine care (all P<0.05).
• 28-day mortality was significantly lower in the CBP group compared to control (P<0.05).
• Greater post-treatment improvements in CC-16, SP-D, respiratory mechanics (Peak, Plat, rate), and arterial oxygenation were observed in the CBP group.

Clinical Implications

Consider CBP as an adjunct in selected SAP-ARDS patients alongside timely antibiotics, with CC-16/SP-D as monitoring biomarkers; randomized trials are needed before routine adoption.

Limitations

• Non-randomized single-center design with potential selection and confounding biases; allocation method not described.
• The combined intervention (CBP plus antibiotics) limits attribution of effects to CBP alone; CBP protocol details not fully specified.

Future Directions

Conduct multicenter randomized trials to validate efficacy, define optimal CBP timing/dose, and isolate CBP-specific effects; evaluate cost-effectiveness and patient selection criteria.