scholarly journals The effect of enteral nutrition on intra-abdominal pressure in severe acute pancreatitis patients

2017 ◽  
Author(s):  
Mingjie Zhang ◽  
Li-Ping Cao ◽  
Guoping Ding
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Occurrence Rate ◽  
Control Group ◽  
Abdominal Pressure ◽  
Therapeutic Effects ◽  
Study Group ◽  
Time Operation ◽  
Operation Rate

Abstract BACKGROUND: To investigate the effect of enteral nutrition (EN) on intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients and the relationship between the decreasion of IAP and the the therapeutic effect of EN. METHODS: Eighty SAP patients were randomly divided into study group and control group (40 patients in each group). Patients in the study group received EN and Patients in the control group received total parenteral nutrition (TPN) for 7 days. Intra-cystic pressure (ICP) of the two groups was measured during treatment period. The outcomes of treatment were observed, APACHE Ⅱ scores, NB data were applied in analysis. RESULTS: The ICP data was lower in the study group than in the control group on days 4 and 5 of treatment (P < 0.05). On days 3-5 of treatment, the APACHE Ⅱ scores of the study group were lower than which of the control group (P < 0.05). Nitrogen balance (NB) date increased significantly in study group than in the control group (P < 0.05). abdominalgia relief time, operation rate were different between the two groups (P < 0.05). The abdominal compartment syndrome (ACS) occurrence rate of the two groups have no significant difference. The ICP data and APACHE Ⅱscores, abdominalgia relief time, operation rate of pancreas debridement show positive correlation (P < 0.05). ICP and NB date show negative correlation (P < 0.05). CONCLUSION: EN can decrease the IAP of SAP, which may be the reason for EN show preventive and therapeutic effects on SAP.

scholarly journals Infusion of Bone Marrow Mesenchymal Stem Cells Attenuates Experimental Severe Acute Pancreatitis in Rats

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Hang Zhao ◽  
Zhiying He ◽  
Dandan Huang ◽  
Jun Gao ◽  
Yanfang Gong ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Acute Pancreatitis ◽  
Mesenchymal Stem Cells ◽  
Survival Rate ◽  
Severe Acute Pancreatitis ◽  
Control Group ◽  
Therapeutic Effects ◽  
Isolation And Characterization ◽  
Marrow Mesenchymal Stem Cells

Background & Aims. Severe acute pancreatitis (SAP) remains a high-mortality disease. Bone marrow (BM) mesenchymal stem cells (MSCs) have been demonstrated to have plasticity of transdifferentiation and to have immunomodulatory functions. In the present study, we assessed the roles of MSCs in SAP and the therapeutic effects of MSC on SAP after transplantation.Methods. A pancreatitis rat model was induced by the injection of taurocholic acid (TCA) into the pancreatic duct. After isolation and characterization of MSC from BM, MSC transplantation was conducted 24 hrs after SAP induction by tail vein injection. The survival rate was observed and MSCs were traced after transplantation. The expression of TNF-αand IL-1βmRNA in the transplantation group was also analyzed.Results. The survival rate of the transplantation group was significantly higher compared to the control group (p<0.05). Infused MSCs were detected in the pancreas and BM 3 days after transplantation. The expression of TNF-αand IL-1βmRNA in the transplantation group was significantly lower than in the control group in both the pancreas and the lungs (p<0.05).Conclusions. MSC transplantation could improve the prognosis of SAP rats. Engrafted MSCs have the capacity of homing, migration, and planting during the treatment of SAP.

Effects of Micro-Ecological Enteral Nutrition on Systemic Inflammatory Response, Bacterial Translocation, and Immune Function in Patients with Severe Acute Pancreatitis

2020 ◽  
Vol 19 (3) ◽  
pp. 240-247
Author(s):  
Yilan Wang ◽  
Hongwei Ye ◽  
Feng Zheng ◽  
Xinsen Zou ◽  
Xianbin Wu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Inflammatory Response ◽  
Immune Function ◽  
Severe Acute Pancreatitis ◽  
Bacterial Translocation ◽  
Severity Index ◽  
Systemic Inflammatory Response ◽  
Mucosal Barrier ◽  
Control Group

We have evaluated the effect of early and late micro-ecological enteral nutrition on systemic inflammatory response, bacterial translocation, and immune function in patients with severe acute pancreatitis. Two weeks after treatment, experimental group receiving early nutritional intervention exhibited a significant increase in intestinal lactobacilli and bifidobacteria, fewer staphylococci, and E. coli, and lower levels of serum endotoxin, D-lactic acid, and diamine oxidase than the group receiving late intervention (control group) (P < 0.05). Also, the serum levels of CD3+ and CD4+ and CD4+/CD8+ ratio significantly increase after 2 weeks of intervention. On the other hand, the level of CD8+ and the Acute Physiology and Chronic Health Evaluation II and Modified Computed Tomography Severity Index scores significantly decreased after 2 weeks of treatment (P < 0.05). The early intervention also led to a significant shortening of time needed for abdominal pain relief, anal exhaustion, resumption of peristaltic sound, and hospitalization. Furthermore, there was a significant increase in overall response rate, and decrease in the incidence rate of complications (P < 0.05). Early micro-ecological enteral nutrition therapy can effectively relieve systemic inflammatory response, prevent intestinal bacterial translocation, restore the function of intestinal mucosal barrier, and alleviate nutritional imbalance in severe acute pancreatitis patients leading to improved immune function, mitigation of the disease, and reduced complications benefiting the recovery of patients.

scholarly journals Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

2021 ◽  
Vol 20 (10) ◽  
pp. 2187-2192
Author(s):  
Chuanmin Liu ◽  
Fei Yuan ◽  
Baowei Wang ◽  
Xuezhen Wang
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Study Groups ◽  
Control Group ◽  
Amylase Level ◽  
Study Group ◽  
Research Subjects ◽  
Ultrasound Guided ◽  
Beneficial Effects ◽  
Abdominal Paracentesis

Purpose: To study the clinical effect of a combination of ultrasound-guided percutaneous abdominal paracentesis drainage (APD) and ulinastatin on severe acute pancreatitis (AP).Methods: A total of 94 patients with severe AP in Intensive Care Unit, Jiaozhou Central Hospital, Qingdao, from December 2017 to December 2018 were selected as the research subjects. They were divided into control and study groups, with 47 patients in each group. Patients in the control group underwent laparotomy drainage, while patients in the study group underwent ultrasound-guidedpercutaneous APD. Patients in both groups received ulinastatin perfusion. Subsequently, clinical effectsand other relevant indicators were determined.Results: Overall response was significantly higher in the study group than in the control group (p < 0.05). The times taken for disappearance of postoperative symptoms, normalization of serum amylase level, and hospitalization were significantly shorter in the study group than in the control group (p < 0.05). For every indicator, the study group exhibited more benefits after than before treatment; however, post-treatment levels of blood glucose, hemodiastase and urinary amylase were better than those in the control group (p < 0.05). Incidence of postoperative complications was lower in the study group than in control group (p < 0.05).Conclusion: The combination of ultrasound-guided percutaneous APD with ulinastatin produces marked beneficial effects on severe AP patients. It facilitates the remission of adverse symptoms, and enhances  normalization of indicator levels. Moreover, it displays low incidence of complications, better prognosis and recovery, and absence of post-operation infections.

scholarly journals Exploration of the Curative Effect of Early Enteral Nutrition Nursing on Patients with Severe Acute Pancreatitis and the Improvement of Patients’ Mental Health and Inflammation Level

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Qigui Xiao ◽  
Lan Lang ◽  
Zhenhua Ma ◽  
Yulin Zhang ◽  
Kedong Xu
Keyword(s):  
Mental Health ◽  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Test Group ◽  
Control Group ◽  
Early Enteral Nutrition ◽  
Curative Effect ◽  
Comparison Of Experiments ◽  
Improvement Effect

In order to explore the curative effect of early enteral nutrition nursing on patients with severe acute pancreatitis and the improvement of patients’ mental health and inflammation levels, this paper compares the curative effect of early enteral nutrition nursing and traditional care on patients with severe acute pancreatitis and the improvement effects of patients’ mental health and inflammation levels through controlled trials. Moreover, this paper combines statistical methods for data processing and visually expresses data through statistical graphs and statistical tables. Through the comparison of experiments, it can be seen that the improvement effect in all aspects of patients in the test group is significantly higher than that in the control group. Finally, through the analysis of the test results, it can be known that the use of early enteral nutrition nursing for patients with acute severe acute pancreatitis has a certain effect in improving their nutritional status, regulating immune function, and promoting mental health.

scholarly journals Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial

2020 ◽  
Author(s):  
Shaahin Shahbazi ◽  
Zahra Vahdat Shariatpanahi ◽  
Erfan Shahbazi
Keyword(s):  
Acute Pancreatitis ◽  
Serum Level ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Rank Test ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Group Frequency ◽  
Hs Crp

Abstract Background: We evaluated effect of ketorolac on reducing the severity of acute pancreatitis.Methods: Fifty six adult patients, with predicted severe acute pancreatitis were randomly divided into two groups. The patients in the study group received intravenous ketorolac, 10 mg, 3 times daily from time of enrollment for a maximum of 5 days as needed along with standard medical treatment. Primary outcome measure was the change in the serum level of hs-CRP. Patients were also followed up in terms of hospitalization duration, need for ICU care, development of organ failure, persistent organ failure, pancreatic necrosis, nutritional assessment and mortality. The study was continued to gather clinical follow up information up to 4 months.Results: Serum level of hs-CRP was significantly lower in the ketorolac group than in the control group on days 3, 4, and 5. Organ failure, pseudocyst formation, acute necrotic collection and intensive care unit transfer occurred non-significantly more in the control group than in the ketorolac group. Median days of hospitalization were significantly lower in the study group than in the control group. Based on the Log rank test, survival within 4 months was marginally lower in the control group (P=0.076). The time to start feeding was significantly shorter in the study group than in the control group with no need to artificial enteral nutrition in the ketorolac group. Frequency of NPO (not per oral) was significantly lower in the ketorolac group.Conclusion: The use of ketorolac may improve feeding and clinical outcomes in severe acute pancreatitis.ClinicalTrials.gov: NCT02885441, Date: August 31, 2016

scholarly journals Increased intra-abdominal pressure: is it of any consequence in severe acute pancreatitis?

HPB ◽  
2006 ◽  
Vol 8 (3) ◽  
pp. 227-232 ◽  
Author(s):  
G. Pupelis ◽  
H. Plaudis ◽  
K. Snippe ◽  
M. Rudakovska
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Abdominal Pressure

Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells (huMSCs) Carrying MicroRNA-342 Relieve Protect Severe Acute Pancreatitis Injury (SAP)

2021 ◽  
Vol 11 (9) ◽  
pp. 1838-1843
Author(s):  
Xiaohong Zhou ◽  
Xuzhong Hao ◽  
Feifei He
Keyword(s):  
Stem Cells ◽  
Acute Pancreatitis ◽  
Mesenchymal Stem Cells ◽  
Umbilical Cord ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Tissue ◽  
Inflammatory Factors ◽  
Control Group ◽  
Human Umbilical Cord Blood ◽  
Human Umbilical Cord

To investigate whether exosomes (exo) derived from human umbilical cord mesenchymal stem cells (huMSCs) and microRNA (miRNA)-342 have a protective effect on severe acute pancreatitis (SAP). Human umbilical cord blood was collected to extract huMSC-exo. With sham-operated mice as control group (n = 10), the other mice were induced to SAP model (n = 20), while 10 of the SAP mice received treatment with huMSC-exo. ELISA was performed to determine amylase and TAP level as well as inflammatory factors and HE staining to evaluate pathological changes of pancreatic tissue. The expression of miR-342 and Shh, Ptchl, and Smo in the Hh signal pathway was detected using RT-qPCR. The expression of miR-342 and the mRNA expression of Shh, Ptchl, and Smo was higher than that in model group (p < 0.05). The level of serum amylase, trypsinogen, and IFN-γ,Fasl, and IL-6 was upregulated in pancreas tissues of SAP mice relative to healthy mice, but their levels were decreased upon treatment with huMSC-exo and slightly higher than those of the control group, just not significantly. Collectively, the huMSC-exo may activate the Hh signaling pathway by regulating the expression of miR-342 increasing the expression of Shh, Ptchl, and Smo, and thereby healing of damaged pancreatic tissues in SAP.

Analysis on Nursing Effect of Octreotide on Acute Pancreatitis

2021 ◽  
Vol 7 (4) ◽  
pp. 300-307
Author(s):  
Chenxia Wu ◽  
Li He
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Symptoms ◽  
Nursing Intervention ◽  
Effective Rate ◽  
Occurrence Rate ◽  
Control Group ◽  
Observation Group ◽  
Clinical Value ◽  
Nursing Satisfaction ◽  
Satisfaction Scale

To explore the clinical value of octreotide therapy and nursing intervention in patients with acute pancreatitis. 120 patients with acute pancreatitis admitted to the Department of Digestive Medicine from June 2018 to August 2019 were selected. Two groups of patients were treated with octreotide. They were randomly divided into observation group (intensive nursing intervention) and control group (routine nursing) with 60 patients in each group. Compared with the control group (81.67%), the total effective rate (93.33%) was higher in the observation group (P<0.05%); After treatment, C reactive protein, lactate dehydrogenase, WBC and hemodiastase of patients in the observation group were better than those in the control group (P<0.05); compared with the control group (18.33%), the occurrence rate of hypoglycemia in the observation group (6.67%) was lower (P<0.05%); At the same time, the Nursing Satisfaction Scale of the observation group (95.00%) was higher than that of the control group (78.33%), (P<0.05%). Patients with acute pancreatitis treated with octreotide and strengthened nursing intervention can obtain more obvious therapeutic effect, so that the clinical symptoms and related laboratory indicators of patients have been significantly improved. At the same time, the clinical value was significant with a lower occurrence rate of hypoglycemia and higher nursing satisfaction scale.

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