Persistent Early Organ Failure

Lytras, Dimitrios; Manes, Konstantinos; Triantopoulou, Charicleia; Paraskeva, Constantina; Delis, Spiros; Avgerinos, Constantinos; Dervenis, Christos

doi:10.1097/mpa.0b013e31815acb2c

Cited by 98 publications

(33 citation statements)

References 30 publications

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“…Thus, POF and MOF may define severe AP. POF has been proposed to define severe AP in view of its association with mortality [5,11,12]. However, it is known that MOF is also associated with a high mortality and it is better characterized in the medical literature [6,7,13,14,15,16,17,18,19,20,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Both cases are associated with high mortality [4,5,6,7,11,12]. Thus, POF and MOF may define severe AP.…”

Section: Discussionmentioning

confidence: 99%

“…This complication may be associated with symptoms such as pain, abdominal compression and complications that might be serious such as infection, rupture, pseudoaneurysm, etc. Pancreatic necrosis without POF or MOF is not associated with higher mortality but with high morbidity [7,12,17,26,27,28,29]. Infection of pancreatic necrosis without POF or MOF is categorized as moderate AP provided it has lower mortality [11,17,26,28,30].…”

Section: Discussionmentioning

confidence: 99%

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Update of the Atlanta Classification of Severity of Acute Pancreatitis: Should a Moderate Category Be Included?

et al. 2010

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Section: Discussionmentioning

confidence: 99%

“…Both cases are associated with high mortality [4,5,6,7,11,12]. Thus, POF and MOF may define severe AP.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Update of the Atlanta Classification of Severity of Acute Pancreatitis: Should a Moderate Category Be Included?

et al. 2010

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“…Disease severity increases with exacerbation of the inflammatory response, local complications and organ failure. Severe acute pancreatitis is defined by persistent organ failure (> 48 h) and is associated with high mortality (35% to 67%) [8][9][10].…”

Section: Acute Pancreatitismentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Bressan

Ball

2017

Anaesthesiol Intensive Ther

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Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target. All critically ill patients with acute pancreatitis should be considered for routine intra-abdominal pressure monitoring. The prevalence and clinical relevance of intra-abdominal hypertension after elective major abdominal operations are underestimated in the literature. Hepato-pancreato-biliary surgery and liver transplantation represent high-risk surgical subspecialties, and routine intra-abdominal hypertension risk assessment to indicate postoperative intra-abdominal pressure monitoring can be recommended. Conservative management of intra-abdominal hypertension should be promptly initiated upon diagnosis. Although abdominal catheter drainage and decompressive laparotomy may be required in refractory cases based on expert clinical judgment, precise indications and timing are still unclear. Implementation of institutional protocols based on the Abdominal Compartment Society reference standards is crucial to optimize both clinical management and research in this evolving area.

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“…Surgical treatment of patients with pancreatic necrosis is based on the differentiated approach to the choice of the method and scope of surgical interventions, depending on the phase of the course of the disease, its clinical and morphological features, a patient's health, and the duration of the disease [1][2][3].…”

mentioning

confidence: 99%

Comparative assessment of different methods of surgical treatment of nonbiliary necrotizing pancreatitis

Rozenko

Synepupov

Sorokin

2018

ZMJ

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Over the last decade, the issue of treatment of acute necrotizing pancreatitis has been requiring special attention because of the growth of this pathology worldwide and high mortality from it, especially with extended infected types of the disease.The aim of the research was to improve results of treatment of patients with nonbiliary necrotizing pancreatitis by optimizing of the surgical tactics, which depend on the extent of necrosis in the pancreas and peripancreatic fat. Materials and methods.The study analyzed results of treatment of 220 patients with acute nonbiliary necrotizing pancreatitis, who were hospitalized in the clinic from 2014 to 2016. The age of the patients ranged from 18 to 80 years, including patients under the age of 50, who accounted for 54 %. Comparison of qualitative features was carried out through analysis of conjugacy tables, using the χ² Pearson criterion (Pearson Chi-square). For four-field tables (for 1 degree of freedom), the Yates's correction was used. When comparing the groups, the level of statistical significance (P) was calculated. At P < 0.05, the differences were considered statistically significant. Results.The research argues that mortality depends not only on the extent of pancreatic necrosis, but also on the choice of method of surgical intervention. Use of puncture-draining operations under ultrasound control and lumbotomy made it possible to reduce postoperative mortality from lesser sac abscess from 6.5 % to 3.9 %, from retroperitoneal phlegmon -from 31.6 % to 15.8 %, and from their combination -from 60.0 % to 33.3 %. In cases of diffuse purulent peritonitis, mortality from laparostomy combined with the programmed sanitation of the abdominal cavity was 40 %; it included cases when carbapenem antibiotics (imipenem/cilastatin, and meropenem) were used in the complex treatment, accounting for 33.3 %, and cases of implementing laparostomy, sanitation, and drainage of the abdominal cavity, making 50 %. Conclusions.The more extensive use of puncture-draining operations under ultrasound control and lumbotomy, as well as laparostomy in combination with the programmed sanitation of the abdominal cavity, allowed to reduce mortality from 26.1 % to 12.1 %.Порівняльне оцінювання різних способів хірургічного лікування небіліарного некротичного панкреатиту О. В. Розенко, Д. М. Синєпупов, А. М. Сорокін Мета роботи -поліпшити результати лікування хворих на небіліарний некротичний панкреатит шляхом оптимізації хірургічної тактики залежно від поширеності некрозу в підшлунковій залозі та парапанкреальній клітковині.Матеріали та методи. Проаналізували результати лікування 220 пацієнтів із гострим небіліарним некротичним пан-креатитом, які перебували на стаціонарному лікуванні у клініці з 2014 до 2016 року. Вік пацієнтів -від 18 до 80 років, 54 % хворих були віком до 50 років. Якісні ознаки порівнювали за допомогою аналізу таблиць спряженості за допо-могою критерію χ² Пірсона (Pearson Chi-square). Для чотирипільних таблиць (для 1 ступеня свободи) використовували поправку Йейтса (Yates's ...

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Persistent Early Organ Failure

Abstract: Persistent organ failure early in the course of acute pancreatitis is a major determinant of outcome. In combination with pancreatic necrosis, survival rate is strongly compromised.

Cited by 98 publications

References 30 publications

Update of the Atlanta Classification of Severity of Acute Pancreatitis: Should a Moderate Category Be Included?

Update of the Atlanta Classification of Severity of Acute Pancreatitis: Should a Moderate Category Be Included?

Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Comparative assessment of different methods of surgical treatment of nonbiliary necrotizing pancreatitis

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