scholarly journals Hydroxyethyl starch resuscitation downregulate pro-inflammatory cytokines in the early phase of severe acute pancreatitis: A retrospective study

2016 ◽  
Vol 12 (5) ◽  
pp. 3213-3220 ◽  
Author(s):  
Qi-Jun Chen ◽  
Zhi-Yong Yang ◽  
Chun-You Wang ◽  
Li-Ming Dong ◽  
Yu-Shun Zhang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Inflammatory Cytokines ◽  
Severe Acute Pancreatitis ◽  
Hydroxyethyl Starch ◽  
Early Phase ◽  
Pro Inflammatory Cytokines

scholarly journals The effect of early resuscitation and ulinastatin on the severe acute pancreatitis in obese patients

2020 ◽  
Vol 24 (3) ◽  
pp. 449-454
Author(s):  
O. Tkachuk ◽  
A. Kebkalo
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Response ◽  
Inflammatory Cytokines ◽  
Severe Acute Pancreatitis ◽  
Interleukin 1 ◽  
Obese Patients ◽  
Ringer’S Lactate ◽  
Bed Days ◽  
Experimental Group ◽  
Pro Inflammatory Cytokines

Annotation. Obesity is a problem of the third millennium. It is known that obesity is a major factor in the development of various diseases, including acute pancreatitis. Obesity itself is a pro-inflammatory condition with elevated levels of the following pro-inflammatory cytokines: tumor necrosis factor (TNF-a), interleukin (IL) IL-10, IL-6, IL-1b. Acute pancreatitis is also a disease based on the pathogenesis of the cytokine reaction and autolysis. Thus, against the background of the already formed inflammatory response, the inflammatory response intensifies and increases, and the level of pro-inflammatory cytokines reaches critical values. The purpose is to study the effect of ulinastatin on the severe acute pancreatitis in obese patients. To refute or confirm the hypothesis among patients with severe acute pancreatitis and obesity (BMI was 37.48±2.19 kg / m2), two groups were randomized. In the first group (experimental) of 18 patients, a step-up approach was performed. In the second group (control), the total number of which was 18 patients, a standard treatment algorithm was performed. The experimental group suggested the use of early resuscitation with Ringer’s lactate and ulinastatin in the first 5 days of the disease. The drug was administered at a dose of 200,000 IU by intravenous infusion for 1 hour 3 times a day for 5 days. In the control group, resuscitation was performed with 0.9% sodium chloride solution without the use of ulinastatin. Hypothesis was tested by monitoring procalciton and C-reactive protein, interleukin-1 and interleukin-6 over a period of 24 hours, 48 hours, 10 days, 15 days, 30 days, 45 and 60 days. The choice of procalcitonin and CRP was made by calculating the relative risk, as the level of CRP> 200mg / l indicated the preservation of severe disease (RR=2.07; 95% CI=1.65-2.59; p=0.01), and an increase in procalcitonin> 1.8 ng / mg was a predictor of infection (RR=2.27; 95% CI=1.083-4.769; p=0.02). The use of ulinastatin during the first 5 days in the experimental group reduced the level of interleukin-1 from 23.64±4.13 to 8.71±2.49 pg / ml (p=0.001; α=0.05), interleukin- 6 – from 29.72±4.27 to 12.43±2.36 pg / ml (p=0.001; α=0.05). The use of resuscitation with Ringer's lactate solution in combination with ulinastatin for 5 days helped to reduce the level of procalciton in 1.8 times (2.89±0.88 compared with 1.8±0.23 ng / mg; p=0.001; α=0.05). The level of CRP during the period of ulinastatin decreased by 41.68 (267.28±114.11 compared with 225.6±84.9 mg / l; p=0.01; α=0.05). In-hospital mortality was significantly lower in the ulinastatin group (16% vs. 69.6%; p=0.0003; α=0.05). Significantly lower proportion of patients (24% compared to 73.9%; p=0.0005; α=0.05) with multiple organ failure among the study group. Organ dysfunction was acquired on day 5 among patients taking ulinastatin. The length of hospital stay was 49.7±4.2 bed-days, while in the comparison group – 56.67±5.84 bed-days (p=0.01; α=0.05). Thus, the use of Ringer-lactate early resuscitation in combination with ulinastatin has improved the treatment of severe acute pancreatitis in obese patients.

Cross-Talk between Oxidative Stress and Pro-Inflammatory Cytokines in Acute Pancreatitis: A Key Role for Protein Phosphatases

2009 ◽  
Vol 15 (26) ◽  
pp. 3027-3042 ◽  
Author(s):  
Javier Escobar ◽  
Javier Pereda ◽  
Alessandro Arduini ◽  
Juan Sandoval ◽  
Luis Sabater ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Acute Pancreatitis ◽  
Inflammatory Cytokines ◽  
Cross Talk ◽  
Protein Phosphatases ◽  
Pro Inflammatory Cytokines

Pro-inflammatory cytokines after an episode of acute pancreatitis: associations with fasting gut hormone profile

2017 ◽  
Vol 67 (4) ◽  
pp. 339-350 ◽  
Author(s):  
Sayali A. Pendharkar ◽  
Ruma G. Singh ◽  
Shayal K. Chand ◽  
Aya Cervantes ◽  
Maxim S. Petrov
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Cytokines ◽  
Hormone Profile ◽  
Gut Hormone ◽  
Pro Inflammatory Cytokines
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