Clinical effects of hemoadsorption with CytoSorb® in patients with severe acute pancreatitis: A case series

2019 ◽  
Vol 42 (4) ◽  
pp. 190-193 ◽  
Author(s):  
Dana Tomescu ◽  
Mihai Popescu ◽  
Corina David ◽  
Simona Dima

Hemoadsorption using CytoSorb® has recently gained attention as a new therapy aimed at modulating the inflammatory response syndrome in critically ill patients. The aim of our study was to assess the clinical effects of CytoSorb in patients with severe acute pancreatitis. We prospectively included 12 patients admitted to the intensive care unit for severe acute pancreatitis. After inclusion, continuous venovenous hemodiafiltration in conjunction with CytoSorb was applied. Clinical data, number of organ dysfunctions, paraclinical data, and vasopressor support were collected before and after the treatment. The use of CytoSorb was associated with a decrease in C-reactive protein from 242 (30, 300) to 180 (20, 252) mg/L (p = 0.04) and procalcitonin from 2.21 (0.01, 15.02) to 1.10 (0.01, 3.79) ng/mL (p = 0.02). The median vasopressor support was 0.1 (0, 0.9) mg/h at the beginning of the treatment and it was discontinued in all cases after the treatment. In conclusion, the use of CytoSorb in patients with severe acute pancreatitis was associated with improved hemodynamics and decreased inflammatory markers.

2020 ◽  
Vol 10 (8) ◽  
pp. 1899-1904
Author(s):  
Minzhen Qin ◽  
Zhihai Liang ◽  
Huiying Yang ◽  
Guoduo Tang ◽  
Mentula A Kalevi

In order to study the clinical effect and safety of endoscopic ultrasound-guided laparoscopic catheter drainage for severe acute pancreatitis, the patients with severe acute pancreatitis were selected as the research objects, the laparoscopic catheter drainage under the guidance of endoscopic ultrasound was carried out, and the efficacy and safety of the operation were evaluated. The results showed that after endoscopic ultrasound-guided laparoscopic catheterization and drainage, the number of C-reactive protein, procalcitonin and white blood cells was decreased, and the inflammation was improved after treatment; the body temperature of 45% patients returned to normal on the first day after operation, and 55% patients returned to normal on the third day after operation; only 1 case of patients followed up had infectious necrosis of pancreas. In summary, endoscopic ultrasound-guided laparoscopic catheter drainage is a safe and effective treatment for severe acute pancreatitis.


2014 ◽  
Vol 21 (12) ◽  
pp. 911-918 ◽  
Author(s):  
Sotirios Vlachos ◽  
Alexandra K. Tsaroucha ◽  
Georgios Konstantoudakis ◽  
Fotini Papachristou ◽  
Gregory Trypsianis ◽  
...  

Author(s):  
Beata Kuśnierz-Cabala ◽  
Jerzy W. Naskalski ◽  
Boguslaw Kędra ◽  
Józefa Panek

AbstractThe aim of this study was to compare diagnostic performance of C-reactive protein (CRP) and poly-C avid ribonuclease (P-RNase) levels in the prediction of a severe clinical course of acute pancreatitis (AP). The study included 36 patients with mild and 20 with severe AP. CRP concentration was measured by an immunonephelometric method and P-RNase activity by the rate of polycytidylate hydrolysis at pH 7.8. At the time of admission, both P-RNase and CRP levels were significantly increased in all patients when compared to healthy subjects (29.2 vs. 18.7 U/l and 91.1 vs. 2.89 mg/l; p<0.001). Up to days 3 and 4 a further increase in P-RNase was observed. On the other hand, the increase in CRP continued only through days 2 and 3 (p<0.001). Severe acute pancreatitis (SAP) and mild acute pancreatitis (MAP) differed significantly with respect to P-RNase levels on all days studied; whereas CRP levels differed significantly on days 2–5 but did not differ at admission. Receiver operating characteristic (ROC) curve function analysis yielded the best sensitivity of SAP detection for P-RNase, equaling 72.2%, at the cut-off point value 65.3 U/l on day 3 after admission. The sensitivity of CRP for detection of SAP was 85.0% at 125.7 mg/l on the 2nd day after admission. Both parameters studied were significantly associated with the severity of the AP clinical course; however, on days 1 and 2 postadmission, P-RNase was more specific for detection of SAP than CRP (94.4% vs. 77.1% on the 1st day and 94.4% vs. 55.5% on the 2nd day). In conclusion, P-RNase has shown an excellent performance for early differentiation of acute necrotizing pancreatitis.


Author(s):  
Yi LIANG ◽  
Xianwei ZHAO ◽  
Fanliang MENG

Background: We aimed to explore the significance of procalcitonin (PCT), C-reactive protein (CRP) and neutrophil ratio (N%) in the early diagnosis, treatment, and prognosis of severe acute pancreatitis (SAP). Methods: A total of 104 patients with SAP (SAP group) and 101 patients with mild acute pancreatitis (MAP) (MAP group) admitted to Affiliated Hospital of Jining Medical University, Jining, China were enrolled. The PCT and CRP in serum were detected by a full-automatic biochemical analyzer, and N% in peripheral blood was measured by a hemocyte analyzer. Results: The peripheral blood PCT, CRP, and N% in the SAP group were significantly higher than those in the MAP group (P<0.001). Multivariate Logistic regression analysis showed that acute physiology and chronic health evaluation II (APACHE II) score, Ranson score, PCT, CRP, and N% were independent risk factors for SAP. The receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of PCT, CRP, and N% in diagnosing SAP were 0.906, 0.840, and 0.834 respectively, while that of combined detection was 0.972. The AUC of PCT, CRP, and N% in diagnosing SAP death were 0.907, 0.900, and 0.894, respectively. Conclusions: Peripheral blood PCT, CRP, and N% contribute to the diagnosis and prognosis of SAP.


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