719 Influence of Fluid Therapy on the Prognosis of Acute Pancreatitis: A Prospective Cohort Study

2010 ◽  
Vol 138 (5) ◽  
pp. S-96
Author(s):  
Enrique de-Madaria ◽  
Gema Soler-Sala ◽  
Inmaculada Lopez-Font ◽  
Pedro Zapater ◽  
Juan Martínez ◽  
...  
2011 ◽  
Vol 106 (10) ◽  
pp. 1843-1850 ◽  
Author(s):  
Enrique de-Madaria ◽  
Gema Soler-Sala ◽  
José Sánchez-Payá ◽  
Inmaculada Lopez-Font ◽  
Juan Martínez ◽  
...  

2021 ◽  
pp. emermed-2020-209771
Author(s):  
Nienke K Koopmans ◽  
Renate Stolmeijer ◽  
Ben C Sijtsma ◽  
Paul A van Beest ◽  
Christiaan E Boerma ◽  
...  

BackgroundLittle is known about optimal fluid therapy for patients with sepsis without shock who present to the ED. In this study, we aimed to quantify the effect of a fluid challenge on non-invasively measured Cardiac Index (CI) in patients presenting with sepsis without shock.MethodsIn a prospective cohort study, CI, stroke volume (SV) and systemic vascular resistance (SVR) were measured non-invasively in 30 patients presenting with sepsis without shock to the ED of a large teaching hospital in the Netherlands between May 2018 and March 2019 using the ClearSight system. After baseline measurements were performed, a passive leg raise (PLR) was done to simulate a fluid bolus. Measurements were then repeated 30, 60, 90 and 120 s after PLR. Finally, a standardised 500 mL NaCl 0.9% intravenous bolus was administered after which final measurements were done. Fluid responsiveness was defined as >15% increase in CI after a standardised fluid challenge.Measurements and main resultsSeven out of 30 (23%) patients demonstrated a >15% increase in CI after PLR and after a 500 mL fluid bolus. Fluid responders had a higher estimated glomerular filtration rate (eGFR) (64 (44–78) vs 37 (23–47), p=0.009) but otherwise similar patient and treatment characteristics as non-responders. Baseline measurements of cardiac output (CO), CI, SV and SVR were unrelated to PLR fluid responsiveness. The change in CI after PLR was strongly positive correlated to the change in CI after a 500 mL NaCl 0.9% fluid bolus (r=0.88, p<0.001).ConclusionThe results of the present study demonstrate that in patients with sepsis in the absence of shock, three out of four patients do not demonstrate a clinically relevant increase in CI after a standardised fluid challenge. Non-invasive CO monitoring in combination with a PLR test has the potential to identify patients who might benefit from fluid resuscitation and may contribute to a better tailored treatment of these patients.


Pancreatology ◽  
2017 ◽  
Vol 17 (4) ◽  
pp. S62
Author(s):  
Rajendra Kumar Jain ◽  
Saransh Jain ◽  
Soumya Jagannath Mahapatra ◽  
Shallu Midha ◽  
Baibaswata Nayak ◽  
...  

PLoS Medicine ◽  
2018 ◽  
Vol 15 (8) ◽  
pp. e1002618 ◽  
Author(s):  
Yuanjie Pang ◽  
Christiana Kartsonaki ◽  
Iain Turnbull ◽  
Yu Guo ◽  
Ling Yang ◽  
...  

Pancreatology ◽  
2014 ◽  
Vol 14 (3) ◽  
pp. S98-S99
Author(s):  
Giulia Martina Cavestro ◽  
Leandro Gioacchino ◽  
Milena Di Leo ◽  
Raffaella Alessia Zuppardo ◽  
Olivia B. Morrow ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040200
Author(s):  
Ahmed E Sherif ◽  
Rory McFadyen ◽  
Julia Boyd ◽  
Chiara Ventre ◽  
Margaret Glenwright ◽  
...  

IntroductionSurvivors of acute pancreatitis (AP) have shorter overall survival and increased incidence of new-onset cardiovascular, respiratory, liver and renal disease, diabetes mellitus and cancer compared with the general population, but the mechanisms that explain this are yet to be elucidated. Our aim is to characterise the precise nature and extent of organ dysfunction following an episode of AP.Methods and analysisThis is an observational prospective cohort study in a single centre comprising a University hospital with an acute and emergency receiving unit and clinical research facility. Participants will be adult patient admitted with AP. Participants will undergo assessment at recruitment, 3 months and 3 years. At each time point, multiple biochemical and/or physiological assessments to measure cardiovascular, respiratory, liver, renal and cognitive function, diabetes mellitus and quality of life. Recruitment was from 30 November 2017 to 31 May 2020; last follow-up measurements is due on 31 May 2023. The primary outcome measure is the incidence of new-onset type 3c diabetes mellitus during follow-up. Secondary outcome measures include: quality of life analyses (SF-36, Gastrointestinal Quality of Life Index); montreal cognitive assessment; organ system physiological performance; multiomics predictors of AP severity, detection of premature cellular senescence. In a nested cohort within the main cohort, individuals may also consent to multiparameter MRI scan, echocardiography, pulmonary function testing, cardiopulmonary exercise testing and pulse-wave analysis.Ethics and disseminationThis study has received the following approvals: UK IRAS Number 178615; South-east Scotland Research Ethics Committee number 16/SS/0065. Results will be made available to AP survivors, caregivers, funders and other researchers. Publications will be open-access.Trial registration numbersClinicalTrials.gov Registry (NCT03342716) and ISRCTN50581876; Pre-results.


2014 ◽  
Vol 12 (4) ◽  
pp. 676-682 ◽  
Author(s):  
Viktor Oskarsson ◽  
Omid Sadr–Azodi ◽  
Nicola Orsini ◽  
Åke Andrén–Sandberg ◽  
Alicja Wolk

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