Efferon LPS Hemoadsorption in Patients With Acute Pancreatitis

The goal of the study is to evaluate the safety and efficacy of multimodal (cytokine and lipopolysaccharide) hemoperfusion using the Efferon® LPS device in combination with hemofiltration (HF) / hemodiafiltration (HDF), with the goal of reducing the severity of organ dysfunction (measured by SOFA score) in patients with acute pancreatitis. Participants will be assigned to two groups for comparison: a control group receiving baseline therapy with HF/HDF, and a treatment group receiving baseline therapy in combination with HF/HDF and Efferon® LPS hemoadsorption.The therapy will be initiated within the first 48 hours after ICU admission and within 8 hours after patient enrollment.

Inclusion Criteria: * ≤ 5 days from the onset of acute pancreatitis * Acute pancreatitis of moderate or severe according to the Atlanta classification (2012) * Acute pancreatitis confirmed by tomography. Modified CTSI Pancreatitis Severity Index Score ≥ 4 points * ≥ 2 points on the Sequential Organ Failure Assessment (SOFA) scale and/or ≥ 2 criteria of Systemic Inflammatory Response Syndrome (SIRS): * Body temperature ≥ 38 °C or ≤ 36 °C * Heart rate ≥ 90/min * Respiratory rate ≥ 20/min or hyperventilation with PaCO₂ ≤ 32 mmHg * Leukocytosis (≥ 12,000/μl) or leukopenia (≤ 4,000/μl) or left shift of leukocyte formula Exclusion Criteria: * SOFA score \> 12 points * Presence of an uncontrolled surgical infection focus * Development of septic complications - signs of infection * Acute pancreatitis as an exacerbation of chronic pancreatitis * Blood triglyceride level \> 1000 mg/dL (11.2 mmol/L) * Liver cirrhosis (\> 6 points by Child-Pugh classification) * Unresolved biliary hypertension syndrome * BMI ≥ 40 * Dementia * Chronic kidney disease stage 4-5 * Acute pulmonary embolism confirmed by CT * Acute myocardial infarction within the last 4 weeks * Acute cerebrovascular accident * Severe congestive heart failure * Uncontrolled bleeding (acute blood loss within the last 24 hours)