High-volume hemofiltration is not preferred for hypertriglyceridemia-induced pancreatitis

Ian N. Monk
2018 Clinical Research in Practice The Journal of Team Hippocrates  
A critical appraisal and clinical application of He WH, Yu M, Zhu Y, et al. Emergent triglyceride-lowering therapy with early high-volume hemofiltration against low-molecular-weight heparin combined with insulin in hypertriglyceridemic pancreatitis: A prospective randomized controlled trial. Clinical Context Our patient is a 23-year-old man who presented to the emergency department due to an acute episode of sharp epigastric pain. The patient complained of associated nausea but no vomiting.
more » ... ut no vomiting. Physical exam was significant for exquisite tenderness in the epigastric area on palpation. Labs drawn in the emergency department revealed a lipase of 4084 units/L and triglycerides of 1014 mg/dL. The patient was diagnosed with hypertriglyceridemiainduced pancreatitis (HTGP) based on the clinical picture and lab findings. The patient was started on IV insulin at 8 units/hour and subcutaneous heparin at 5000 units/8 hours in the MICU. One consultant recommended the use of plasmapharesis as potential therapy for HTGP. Clinical Question Is plasmapheresis superior to insulin and heparin for the acute treatment of hypertriglyceridemia-induced pancreatitis? Research Article He WH, Yu M, Zhu Y, et al. Emergent triglyceride-lowering therapy with early high-volume hemofiltration against low-molecularweight heparin combined with insulin in hypertriglyceridemic pancreatitis: A prospective randomized controlled trial.
doi:10.22237/crp/1530619200 fatcat:qamzssivpvgfhgq34c37e7iaa4