AIM： To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis （SAP） in China. METHODS： We carried out a search of Pub-Medline and Chinese Biomedical Disk datab...AIM： To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis （SAP） in China. METHODS： We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were： continuous or long-term veno-venous hemofiltration （CVVH/LVVH）, short-term veno-venous hemofiltration （SVVH）, SVVH plus peritoneal dialysis （PD）, and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed. RESULTS： The SVVH only technique was the least costly modality, $5809 （44449 RMB）, and was selected as the baseline treatment modality. SVVH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CWH/ LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SVVH only and SVVH plus PD arms overlapped in C/survival ratio. CONCLUSION： The role of early veno-venous hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP.展开更多
The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 ty...The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 types, each of three capacities： 100 mL, 250 mL and 500 mL） following clinical use for in-patients at Peking University Third Hospital were collected during Sept. and Oct. 2007. The volume of residual drug solution was determined. Hospital pharmacy records were used to determine the potential economic implications of discarding residual drug solutions. The mean residual volumes ranged from 0.38 mL to 4.80 mL and, in general, residual volume increased with increasing container capacity. The residual volumes for one type of double-port soft bag were significantly lower than the residual volumes for all other containers of the same capacity （P〈0.05）, including glass and semi-rigid plastic bottles. Highest residual volumes were observed for the single-port soft bag. Estimates of the value of discarded residual drug solution ranged from approximately US $15,000 to US $150,000 per annum in our hospital. Infusion container design has a major influence on residual drug solution volumes following intravenous infusion. Appropriate choice of bag design remains an important consideration for the economics and efficacy of infusion treatment in Chinese hospitals.展开更多
基金Supported by The National Natural Science Foundation of China, No.30500684 and Clinical Research Foundation for Residency Granted by the Cooperative Project of West China Hospital and Daiichi Pharmaceutical Co. Ltd., the level Ⅰ
文摘AIM： To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis （SAP） in China. METHODS： We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were： continuous or long-term veno-venous hemofiltration （CVVH/LVVH）, short-term veno-venous hemofiltration （SVVH）, SVVH plus peritoneal dialysis （PD）, and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed. RESULTS： The SVVH only technique was the least costly modality, $5809 （44449 RMB）, and was selected as the baseline treatment modality. SVVH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CWH/ LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SVVH only and SVVH plus PD arms overlapped in C/survival ratio. CONCLUSION： The role of early veno-venous hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP.
文摘The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 types, each of three capacities： 100 mL, 250 mL and 500 mL） following clinical use for in-patients at Peking University Third Hospital were collected during Sept. and Oct. 2007. The volume of residual drug solution was determined. Hospital pharmacy records were used to determine the potential economic implications of discarding residual drug solutions. The mean residual volumes ranged from 0.38 mL to 4.80 mL and, in general, residual volume increased with increasing container capacity. The residual volumes for one type of double-port soft bag were significantly lower than the residual volumes for all other containers of the same capacity （P〈0.05）, including glass and semi-rigid plastic bottles. Highest residual volumes were observed for the single-port soft bag. Estimates of the value of discarded residual drug solution ranged from approximately US $15,000 to US $150,000 per annum in our hospital. Infusion container design has a major influence on residual drug solution volumes following intravenous infusion. Appropriate choice of bag design remains an important consideration for the economics and efficacy of infusion treatment in Chinese hospitals.
