The effects of fluid resuscitation according to PiCCO on the early stage of severe acute pancreatitis

Pancreatology ◽  
2015 ◽  
Vol 15 (5) ◽  
pp. 497-502 ◽  
Author(s):  
Yun Sun ◽  
Zhong-hua Lu ◽  
Xin-shu Zhang ◽  
Xiao-ping Geng ◽  
Li-jun Cao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Fluid Resuscitation ◽  
Early Stage

scholarly journals The impact of fluid resuscitation via colon on patients with severe acute pancreatitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tongtian Ni ◽  
Ying Chen ◽  
Bing Zhao ◽  
Li Ma ◽  
Yi Yao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Fluid Resuscitation ◽  
Early Stage ◽  
Pure Water ◽  
Complementary Therapy ◽  
Kaplan Meier ◽  
Before And After ◽  
First Onset ◽  
The Impact

AbstractSevere acute pancreatitis (SAP) is a life-threatening disease. Fluid Resuscitation Via Colon (FRVC) may be a complementary therapy for early controlled fluid resuscitation. But its clinical application has not been reported. This study aims to explore the impact of FRVC on SAP. All SAP patients with the first onset within 72 h admitted to the hospital were included from January 2014 to December 2018 through electronic databases of Ruijin hospital and were divided into FRVC group (n = 103) and non-FRVC group (n = 78). The clinical differences before and after the therapy between the two groups were analyzed. Of the 181 patients included in the analysis, the FRVC group received more fluid volume and reached the endpoint of blood volume expansion ahead of the non-FRVC group. After the early fluid resuscitation, the inflammation indicators in the FRVC group were lower. The rate of mechanical ventilation and the incidence of hypernatremia also decreased significantly. Using pure water for FRVC was more helpful to reduce hypernatremia. However, Kaplan–Meier 90-day survival between the two groups showed no difference. These results suggest that the combination of FRVC might benefit SAP patients in the early stage of fluid resuscitation, but there is no difference between the prognosis of SAP patients and that of conventional fluid resuscitation. Further prospective study is needed to evaluate the effect of FRVC on SAP patients.

scholarly journals Fluid resuscitation via colon alleviates systemic inflammation in rats with early-stage severe acute pancreatitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tongtian Ni ◽  
Lili Xu ◽  
Silei Sun ◽  
Li Ma ◽  
Bing Zhao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Systemic Inflammation ◽  
Fluid Resuscitation ◽  
Early Stage ◽  
Sodium Taurocholate ◽  
Proximal Colon ◽  
Organ Injury ◽  
Intercellular Adhesion Molecule ◽  
Dependent Manner

AbstractFluid resuscitation via colon (FRVC) is a complementary therapeutic procedure for early-stage cases of severe acute pancreatitis (SAP). The expression of intestinal dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) regulates systemic inflammation. This study aimed to investigate the effect of FRVC on the expression of DC-SIGN in the colon tissue of SAP rats and its effect on the early response of systemic inflammatory and multiple organ injury. SAP was induced in rats via retrograde injection of sodium taurocholate into the biliopancreatic duct. DC-SIGN expression of appeared in the proximal and distal colon. Histological characteristics and inflammatory cytokines were examined to compare the effect of FRVC and intravenous fluid resuscitation (IVFR). The results showed that DC-SIGN expression in the proximal colon increased in a time-dependent manner in the early-stage of SAP rats. FRVC inhibited DC-SIGN expression in the proximal colon. Both FRVC and IVFR alleviated histological injuries of the pancreas and colon. However, FRVC had an advantage over IVFR in alleviating lung injury and reducing serum TNF-α, IL-6 and LPS. These results suggest that FRVC treatment might help suppress systemic inflammation and prevent subsequent organ failure in early-stage SAP rats likely through inhibiting DC-SIGN expression in the proximal colon.

scholarly journals Fluid Resuscitation via Colon Alleviates Systemic Inflammation in Early Stage of Rats With Severe Acute Pancreatitis

2021 ◽  
Author(s):  
Tongtian Ni ◽  
Lili Xu ◽  
Silei Sun ◽  
Li Ma ◽  
Bing Zhao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Systemic Inflammation ◽  
Fluid Resuscitation ◽  
Early Stage ◽  
Sodium Taurocholate ◽  
Proximal Colon ◽  
Organ Injury ◽  
Intercellular Adhesion Molecule ◽  
Dependent Manner

Abstract Fluid Resuscitation Via Colon (FRVC) is a complementary therapy for severe acute pancreatitis (SAP) in early stage. The expression of intestinal dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) has been found to regulate systemic inflammation. The present study aimed to investigate the effect of FRVC on the expression of DC-SIGN in the colon tissue of SAP rats and its effect on the early response of systemic inflammatory and multiple organ injury. SAP rats were induced by retrograding injection of sodium taurocholate into biliopancreatic duct. The expression of DC-SIGN was observed in the proximal and distal colons. Histological characteristics and inflammatory cytokines were examined to compare the effect of FRVC and intravenous fluid resuscitation (IVFR) treatment. The results showed that the expression of DC-SIGN in the proximal colon increased in a time-dependent manner in early stage of SAP rats. FRVC inhibits the expression of DC-SIGN in the proximal colon. Both FRVC and IVFR treatment alleviates histological injury of pancreas and colon. However, FRVC had an advantage over IVFR in alleviating lung injury and reducing Serum TNF-α, IL-6 and LPS. These results suggest that FRVC treatment might be helpful in suppressing systemic inflammation and preventing subsequent organ failure in early stage of SAP rats. The mechanism might be to inhibit the expression of DC-SIGN protein in the proximal colon.

Urinary nitrogen excretion at the early stage of severe acute pancreatitis

2020 ◽  
Vol 21 (4) ◽  
pp. 131-134
Author(s):  
O. G. Sivkov ◽  
◽  
A. O. Sivkov ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Ideal Body Weight ◽  
Nitrogen Excretion ◽  
The Third ◽  
Ideal Body ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen ◽  
The Ideal

Aim. To study urinary nitrogen excretion at the early stage of severe acute pancreatitis. Materials and methods. Prospective, single-center, cohort study. Inclusion criteria: diagnosis of acute pancreatitis and presence of at least one of the predictors of severe course. Among all patients (n = 72), a cohort of patients with severe acute pancreatitis (n = 32) was allocated. Three groups were formed in it: the first one – all patients, the second one – survivors (n = 24), the third one – deceased (n = 8). Urinary nitrogen excretion was determined using the Deacon formula. Measurements were performed on the first, third and fifth days of the disease. Statistical processing of the material was carried out by the SPSS software package. The null hypothesis was rejected at p < 0.05. Results. In the first week of the disease in all groups, the maximum urinary nitrogen excretion occurs on the 3rd day. When comparing the results of the second and third groups, it was found that the urinary nitrogen excretion on the first and fifth days did not have a statistically significant difference between the groups (respectively, p = 0.138, p = 0.572), and the results of the third day have (p = 0.014). A similar pattern remains when recalculating the nitrogen loss in the urine to the ideal weight; for the third day, the differences between the second and third groups were statistically significant (p = 0.007). ROC analysis of urinary nitrogen excretion of the third day calculated to the ideal body weight showed an area under the curve of 0.813 (p < 0.009). The value at the cut-off point is defined as 0.65 g/kg/day. The sensitivity of the model was 0.75%, specificity – 0.83%. Conclusion. If in a patient with acute pancreatitis, there is urinary nitrogen excretion on the third day from the onset of the disease, calculated to an ideal body weight of ≥ 0.65 g/kg/day, an unfavorable outcome of the disease is predicted.

scholarly journals Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Dejan V. Radenkovic ◽  
Colin D. Johnson ◽  
Natasa Milic ◽  
Pavle Gregoric ◽  
Nenad Ivancevic ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Treatment ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Severe Acute Pancreatitis ◽  
Fluid Resuscitation ◽  
Interventional Treatment ◽  
Invasive Approach ◽  
Aggressive Fluid Resuscitation ◽  
Abdominal Compartment

Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

Sa1368 Prediction for Complications of Severe Acute Pancreatitis Using Perfusion CT in the Early Stage

2013 ◽  
Vol 144 (5) ◽  
pp. S-276 ◽  
Author(s):  
Yoshihisa Tsuji ◽  
Tsubasa Watanabe ◽  
Hiroshi Yamamoto ◽  
Tsutomu Chiba
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Perfusion Ct

Faster Rate of Initial Fluid Resuscitation in Severe Acute Pancreatitis Diminishes In-Hospital Mortality

Pancreatology ◽  
2009 ◽  
Vol 9 (6) ◽  
pp. 770-776 ◽  
Author(s):  
Timothy B. Gardner ◽  
Santhi Swaroop Vege ◽  
Suresh T. Chari ◽  
Bret T. Petersen ◽  
Mark D. Topazian ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Mortality ◽  
Severe Acute Pancreatitis ◽  
Fluid Resuscitation
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