Acute pancreatitis conditioned mesenteric lymph causes preventable cardiac dysfunction

Shanbhag, S.; Choong, Bernard; Premkumar, Rakesh; Phang, Kian Liun; Petrov, Maxim S.; Windsor, John A.; Phillips, Anthony

doi:10.1016/j.pan.2012.12.310

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IL‐1β and IL‐10) are prevented from reaching the systemic circulation by external lymph drainage, which also improves cellular immune function and reduces bacterial translocation . We have demonstrated that the cardiac dysfunction associated with experimental AP can be prevented by thoracic duct ligation . Thoracic duct ligation and lymph diversion have been shown to ameliorate lung injury in experimental AP.…”

Section: Persistent Organ Failurementioning

confidence: 89%

“…34 We have demonstrated that the cardiac dysfunction associated with experimental AP can be prevented by thoracic duct ligation. 35 Thoracic duct ligation 36 and lymph diversion 37 have been shown to ameliorate lung injury in experimental AP. This is demonstrated by prevention of neutrophil priming and accumulation in pulmonary tissues 38 ; reduced lung permeability, 39 and histological improvement in lung injury.…”

Section: Persistent Organ Failurementioning

confidence: 99%

See 1 more Smart Citation

Novel strategies for the treatment of acute pancreatitis based on the determinants of severity

Windsor

Escott

Brown

et al. 2017

J of Gastro and Hepatol

View full text Add to dashboard Cite

Acute pancreatitis (AP) is a common disease for which a specific treatment remains elusive. The key determinants of the outcome from AP are persistent organ failure and infected pancreatic necrosis. The prevention and treatment of these determinants provides a framework for the development of specific treatment strategies. The gut-lymph concept provides a common mechanism for systemic inflammation and organ dysfunction. Acute and critical illness, including AP, is associated with intestinal ischemia and drastic changes in the composition of gut lymph, which bypasses the liver to drain into the systemic circulation immediately proximal to the major organ systems which fail. The external diversion of gut lymph and the targeting of treatments to counter the toxic elements in gut lymph offers novel approaches to the prevention and treatment of persistent organ failure. Infected pancreatic necrosis is increasingly treated with less invasive techniques, the mainstay of which is drainage, both endoscopic and percutaneous. Further improvements will occur with the strategies to accelerate liquefaction and through a fundamental redesign of drains, both of which will increase drainage efficacy. The determinants of severity and outcome in patients admitted with AP provide the basis for innovative treatment strategies. The priorities are to translate the gut-lymph concept to clinical practice and to improve the design and active use of drains for infected complications of AP.

show abstract

Section: Persistent Organ Failurementioning

confidence: 89%