A patient with severe acute pancreatitis successfully treated with a new critical care procedure

被引：12

作者：

Moriguchi, T ^{[1
]}

Hirasawa, H ^{[1
]}

Oda, S ^{[1
]}

Shiga, H ^{[1
]}

Nakanishi, K ^{[1
]}

Matsuda, K ^{[1
]}

Nakamura, M ^{[1
]}

Yokohari, K ^{[1
]}

Hirano, T ^{[1
]}

Hirayama, Y ^{[1
]}

Watanabe, E ^{[1
]}

机构：

[1] Chiba Univ, Grad Sch Med, Dept Emergency & Crit Care Med, Chiba 2808677, Japan

来源：

THERAPEUTIC APHERESIS | 2002年 / 6卷 / 03期

关键词：

continuous hemodiafiltration; mediators; cytokines; severe acute pancreatitis; selective digestive decontamination; bacterial translocation; systemic inflammatory response syndrome;

D O I：

10.1046/j.1526-0968.2002.00435.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

It has been accepted widely that excessive humoral mediators play important roles in the pathogenesis of organ. failure in patients with severe acute pancreatitis (SAP) and that infection of the pancreas due to bacterial translocation (BT) is the most frequent cause of death in SAP. On the other hand, it has been reported that continuous hemodiatiltration (CHDF) removes humoral mediators on hypercytokinemic patients such as those with systemic inflammatory response syndrome. Furthermore, several clinical studies have demonstrated that selective digestive decontamination (SDD) effectively eliminates aerobic Gram-negative bacteria from the intestinal tract and reduces the incidence of septic complications in SAP. Herein we report a case of SAP who was treated successfully with intensive care including CHDF and SDD. Thus, this case report suggests that CHDF aimed at removing causative humoral mediators and SDD for the prevention of BT are useful new tools for the management of SAP.

引用

页码：221 / 224

页数：4

共 18 条

[11] CONTROLLED CLINICAL-TRIAL OF SELECTIVE DECONTAMINATION FOR THE TREATMENT OF SEVERE ACUTE-PANCREATITIS [J].

LUITEN, EJT ;

HOP, WCJ ;

LANGE, JF ;

BRUINING, HA .

ANNALS OF SURGERY, 1995, 222 (01) :57-65

[12] Current topics on cytokine removal technologies [J].

Matsuda, K ;

Hirasawa, H ;

Oda, S ;

Shiga, H ;

Nakanishi, K .

THERAPEUTIC APHERESIS, 2001, 5 (04) :306-314

[13]

Morken J, 2001, Curr Opin Crit Care, V7, P268, DOI 10.1097/00075198-200108000-00010

[14] DECREASED MORTALITY OF SEVERE ACUTE-PANCREATITIS AFTER PROXIMAL CYTOKINE BLOCKADE [J].

NORMAN, JG ;

FRANZ, MG ;

FINK, GS ;

MESSINA, J ;

FABRI, PJ ;

GOWER, WR ;

CAREY, LC .

ANNALS OF SURGERY, 1995, 221 (06) :625-634

[15]

OHTAKE Y, 1991, CONTRIB NEPHROL, V93, P215

[16] Intra-abdominal hypertension and abdominal compartment syndrome [J].

Sieh, KM ;

Chu, KM ;

Wong, J .

LANGENBECKS ARCHIVES OF SURGERY, 2001, 386 (01) :53-61

[17] Gut origin sepsis, macrophage function, and oxygen extraction associated with acute pancreatitis in the rat [J].

Wang, XD ;

Andersson, R ;

Soltesz, V ;

Leveau, P ;

Ihse, I .

WORLD JOURNAL OF SURGERY, 1996, 20 (03) :299-308

[18]

Yamauchi J, 2001, J Hepatobiliary Pancreat Surg, V8, P195, DOI 10.1007/s005340170016

← 1 2 →