scholarly journals Assessment of the severity of acute destructive pancreatitis for proper treatment selection

2013 ◽  
Vol 94 (5) ◽  
pp. 633-636 ◽  
Author(s):  
A A Valeev
Keyword(s):  
Organ Failure ◽  
Disease Severity ◽  
Clinical Laboratory ◽  
Multiple Integral ◽  
Simplified Acute Physiology Score ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction Score ◽  
Urgent Surgery ◽  
Integral Scales ◽  
Special Examination

The review covers the most common integrated scales used for the assessment of severity of acute destructive pancreatitis. The use of those scales in the surgical in-patient department is discussed. Different views of Russian and foreign pancreatologists on the use of integrated scales to predict the disease outcome according to various criteria (clinical, laboratory, and special examination methods) are presented. Because of the acute pancreatitis morphological forms variety at admission for urgent surgery, there is a need for a comprehensive assessment of the disease severity in such patients. First stage of assessment is based on clinical data obtained at admission; correlation with systemic organ failure is also taken into account. This approach helps to distinguish mild, moderate and severe clinical course of disease. The use of multiple integral scales used for clinical assessment, with the number of possible options exceeding 20, is widely applied when the patient is admitted. The surgeon’s selection of a scale for assessment of the disease severity depends on the available equipment and the time for evaluation. Currently, the multi-parameter prognostic scales Ranson (1972), APACHE II (Acute Physiology And Chronic Health Evaluation, 1990), Glasgow-Imrie (1984), SAPS (Simplified acute physiology score, 1984), MODS (Multiple Organ Dysfunction Score, 1995), SOFA (Sepsis-related Organ Failure. 1996) are considered to be most objective. The use of these scales allows improving the prediction of outcome and necrotic complications by several times.

scholarly journals APPLICATION PROCEDURE EARL Y DIFERENTIAL DIAGNOSIS OF DIFERENT FORMS OF ODONTO - GENIC SEPSIS IN THE KURSK REGIONAL CLINICAL HOSPITAL WITH INTEGRATED SCALES APACHE-2 SOFA SAPS-2 SIRS

2014 ◽  
Vol 10 (6) ◽  
pp. 28-30
Author(s):  
А. Будаев ◽  
A. Budaev ◽  
А. Громов ◽  
A. Gromov ◽  
А. Зыкин ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Predictive Capability ◽  
Integral Scales ◽  
Medical Academy ◽  
Application Procedure ◽  
State Medical Academy ◽  
Medical University

<p>This work was devoted to improve the efficiency of diagnosis and treatment of patients with odontogenic phlegmons by studying predictive capability of different integral scales. The results of the use of methods for early differential diagnosis of various forms of odontogenic sepsis (development departments Kursk State Medical University and the Voronezh State Medical Academy. NNBurdenko): more than 30 points (the presence of multiple organ failure) – 22 patients (73,3%); less than 30 points (no organ failure) – 8 patients (26,7%). </p>

scholarly journals Perkembangan diagnosis sepsis pada anak

Sari Pediatri ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 237
Author(s):  
Anindita Wulandari ◽  
Sri Martuti ◽  
Pudjiastuti Kaswadi
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Multiple Organ Dysfunction Score ◽  
Logistic Organ Dysfunction ◽  
Failure Assessment

Sepsis merupakan salah satu penyebab utama morbiditas dan mortalitas bayi dan anak di seluruh dunia. Sepsis awalnya didefinisikan sebagai kecurigaan atau infeksi yang terbukti, disertai kondisi klinis SIRS (systemic inflammatory response syndrome), tetapi definisi tersebut kini ditinggalkan. Sesuai konsensus mengenai sepsis terbaru, sepsis didefinisikan sebagai keadaan disfungsi/gagal organ yang mengancam nyawa, disebabkan oleh respon pejamu yang tidak teregulasi terhadap infeksi. Penilaian disfungsi/gagal organ pada anak menggunakan beberapa sistem penilaian, antara lain, Pediatric Multiple Organ Dysfunction Score (P-MODS), Pediatric Logistic Organ Dysfunction (PELOD), Pediatric Logistic Organ Dysfunction–2 (PELOD-2), dan pada konsensus terbaru diperkenalkannya sistem Pediatric Sequential Organ Failure Assessment (pSOFA) yang diadaptasi dari sistem Sequential Organ Failure Assessment (SOFA) dengan hasil validasi menunjukkan bahwa pSOFA memberikan hasil yang sama baik dengan sistem penilaian yang lain. Di Indonesia saat ini, PELOD-2 merupakan sistem penilaian disfungsi organ yang direkomendasikan oleh Ikatan Dokter Anak Indonesia (IDAI) dalam mendiagnosis sepsis pada anak.

scholarly journals Use of CT-Based Scoring System in Assessment of Pancreatitis Severity

2019 ◽  
Vol 7 (23) ◽  
pp. 3997-4003
Author(s):  
Madina Ermekova
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Death Rate ◽  
Clinical Laboratory ◽  
Early Stage ◽  
Multiple Organ ◽  
Important Indicator ◽  
Pancreas Necrosis

BACKGROUND: Severity of AP is an important indicator of death rate, playing a crucial role in defining a correct dealing with a patient at his/her initial admission, in deciding on the need to transfer a patient to the intensive care unit. Many studies point out a direct relation between the death rate and the number of affected organs. In light of this, looking for the new criteria of multiple organ failure is still useful in clinical practice. Typically, assessment of multiple organ failure with patients undergoing treatment in the intensive care unit is carried out with the use of various integrated scores based both on clinical laboratory assessment of patient’s condition and on data obtained by advanced imaging methods. However, many scientists point out that the facilities of diagnostic radiology, including in particularly computerised tomography, are not used to the full extent. AIM: We developed a CT score for assessment of pancreatitis severity that takes into consideration not only alterations of the pancreas but also enables evaluation of multiple organ failure with the examined patients. METHODS: We have examined 100 patients with suspected pancreatitis. Among them 30 patients had pancreatitis without alterations of the vital organs; 70 patients had alterations of the vital organs, suffered organ or multiple organ failure and received treatment in the surgery unit and intensive care unit of the Department of Surgical Conditions of Karaganda Medical University. RESULTS: Because of CT results, based on the proposed score, we assessed a degree of pancreas necrosis, analysed the relation between organ failure and degree of pancreas necrosis. Finally, we evaluated the connection between multiple organ failure and the specific failure of one organ and the presence of necrosis and death rate. CONCLUSION: The proposed score for CT-based assessment of pancreatitis severity can be used not only for identification but also for prediction of organ failure at the early stage of pancreatitis to a high accuracy as compared to conventional CT systems for assessment of the condition of patients affected by pancreatitis. It can also be used to differentiate the severity of organ failure and the number of affected organs.

scholarly journals Predicting the clinical trajectory in critically ill patients with sepsis: a cohort study

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Peter M. C. Klein Klouwenberg ◽  
◽  
Cristian Spitoni ◽  
Tom van der Poll ◽  
Marc J. Bonten ◽  
...  
Keyword(s):  
At Risk ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Disease Severity ◽  
Model Performance ◽  
Multiple Organ ◽  
Clinical Trial Registration ◽  
Disease States ◽  
C Statistic ◽  
In Silico Modeling

Abstract Background To develop a mathematical model to estimate daily evolution of disease severity using routinely available parameters in patients admitted to the intensive care unit (ICU). Methods Over a 3-year period, we prospectively enrolled consecutive adults with sepsis and categorized patients as (1) being at risk for developing (more severe) organ dysfunction, (2) having (potentially still reversible) limited organ failure, or (3) having multiple-organ failure. Daily probabilities for transitions between these disease states, and to death or discharge, during the first 2 weeks in ICU were calculated using a multi-state model that was updated every 2 days using both baseline and time-varying information. The model was validated in independent patients. Results We studied 1371 sepsis admissions in 1251 patients. Upon presentation, 53 (4%) were classed at risk, 1151 (84%) had limited organ failure, and 167 (12%) had multiple-organ failure. Among patients with limited organ failure, 197 (17%) evolved to multiple-organ failure or died and 809 (70%) improved or were discharged alive within 14 days. Among patients with multiple-organ failure, 67 (40%) died and 91 (54%) improved or were discharged. Treatment response could be predicted with reasonable accuracy (c-statistic ranging from 0.55 to 0.81 for individual disease states, and 0.67 overall). Model performance in the validation cohort was similar. Conclusions This prediction model that estimates daily evolution of disease severity during sepsis may eventually support clinicians in making better informed treatment decisions and could be used to evaluate prognostic biomarkers or perform in silico modeling of novel sepsis therapies during trial design. Clinical trial registration ClinicalTrials.gov NCT01905033

Organ failure scoring

2016 ◽  
Author(s):  
Rui Moreno
Keyword(s):  
Organ Failure ◽  
Organ Dysfunction ◽  
Prediction Models ◽  
Daily Basis ◽  
Multiple Organ ◽  
Response To Therapy ◽  
Multiple Organ Dysfunction Score ◽  
Logistic Organ Dysfunction ◽  
General Outcome ◽  
Organ Systems

The general outcome prediction models were not, by design, developed to track individual patients. They provided an indication of death risks for groups of ICU patients. Hence, investigators created organ failure scores. Instruments, such as Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score, or Logistic Organ Dysfunction Score are designed to evaluate separately the six most important organ systems in critically-ill patients sequentially, taken on a daily basis. Easy to perform, designed to be done at bedside, they do not forecast ICU or hospital mortality (apart from the SOFA score), but are very useful in describing the patient and his response to therapy.

Hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings

2019 ◽  
Vol 43 (3) ◽  
pp. 143-149
Author(s):  
Li Li ◽  
Wang Bo ◽  
Huang Chen ◽  
Liu XiaoWei ◽  
Liu Hongbao ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Interleukin 10 ◽  
Simplified Acute Physiology Score ◽  
Multiple Organ ◽  
Interleukin 4 ◽  
Clinical Effects ◽  
Wasp Sting ◽  
Hemodynamic Variables ◽  
Wasp Stings

Purpose: This study aimed to evaluate the clinical effects of hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings and investigate its impacts on cytokines. Methods: A total of 12 patients with multiple organ failure after wasp stings admitted to Xijing Hospital were included in the present study between January 2017 and January 2019. All patients received hemoperfusion plus continuous veno-venous hemofiltration treatment in addition to conventional treatment after admission. Procedure of treatment was conducted as the following: hemoperfusion (2 h/day) and followed by continuous veno-venous hemofiltration (22 h/day) for at least 5 days. Patients’ clinical features, serum laboratory tests, and hemodynamic variables were monitored. The blood samples were taken to measure the changes of plasma cytokines. Results: All 12 patients survived in the observation period. After hemoperfusion plus continuous veno-venous hemofiltration treatment, there were significant improvements in indicators of liver function, renal function, state of consciousness, and mediators in blood circulation, including alanine transaminase, aspartate transaminase, creatine kinase, blood urea nitrogen, serum creatinine, myoglobin, C-reactive protein, and so on. In these patients, acid–base metabolism returned to normal levels; Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II score, and Sequential Organ Failure Assessment score lowered markedly. Furthermore, the plasma levels of interleukin 1β, interleukin 4, interleukin 6, interleukin 8, and interleukin 10 in these patients were significantly decreased; no significant change was shown in the level of tumor necrosis factor α. Conclusion: Our results revealed that hemoperfusion plus continuous veno-venous hemofiltration was effective in the management of patients with multiple organ failure after wasp sting via the non-specific removal of the wasp venom and inflammatory cytokines.

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