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

Abstract

OBJECTIVE: To investigate the effects of continuous blood purification (CBP) combined with antibiotics on pulmonary surfactant protein D (SP‐D), Clara cell protein‐16 (CC‐16), and prognosis in patients with severe acute pancreatitis (SAP) complicated by acute respiratory distress syndrome (ARDS). METHODS: A total of 128 patients with SAP and ARDS treated at Fudan University Shanghai Cancer Center from June 2021 to June 2023 were enrolled. Patients were divided into two groups: a control group (n=64) receiving routine treatment (gastrointestinal decompression, somatostatin administration, nutritional support, correction of water‐electrolyte imbalance, and microcirculation improvement) and an observation group (n=64) treated with CBP combined with antibiotics. Clinical data, including the pancreatic edema resolution time, ventilator weaning time, and hospital stay, were compared between groups. Additional comparisons included intra‐abdominal pressure (IAP), blood amylase (AMS), urinary amylase (UAMY), inflammatory markers [tumor necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6), interleukin‐1β (IL‐1β)], respiratory mechanics indices [airway peak pressure (Peak), airway plateau pressure (Plat), respiratory rate (F)], and blood oxygen levels [partial pressure of arterial oxygen (PaO2), PaO2/fraction of inspired oxygen (FiO2)] before and after treatment. RESULTS: The observation group demonstrated significantly better outcomes compared to the control group in terms of pancreatic edema resolution time, ventilator weaning time, hospital stay, and other indicators (all P<0.05). The 28‐day mortality rate in the observation group was significantly lower than in the control group (P<0.05). Post‐treatment levels of CC‐16, SP‐D, Peak, Plat, and other indicators improved significantly in both groups compared to baseline (all P<0.05). The observation group exhibited significantly greater improvements in PaO2 and PaO2/FiO2 compared to the control group (all P<0.05). CONCLUSION: CBP combined with antibiotics significantly improves clinical symptoms, reduces inflammatory markers, enhances prognosis, and lowers mortality rates in patients with SAP complicated by ARDS.