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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The balance between intravascular volume, oxygen transport, and arterial oxygenation is delicate in patients with adult respiratory distress syndrome (ARDS). Recently, we used continuous arteriovenous countercurrent hemodialysis (CAVH-D) in 14 nonoliguric patients who had severe ARDS. The cause of the ARDS was pancreatitis in 1 patient, trauma in 10 patients, and postoperative in 4 patients. All patients were edematous, in marked positive fluid balance but not intravascularly overloaded before institution of CAVH-D. Transfemoral CAVH-D was instituted and managed by the SICU staff. Patients underwent CAVH-D for a mean of 65.2 hours (range, 12-140 hours) and cleared a mean of 480 mL/h of filtrate. The only complication was one patient who bled from a loose tubing connection. Three patients were grossly unstable when CAVH-D was begun. Their mean cardiac index (CI) was 2.3 L/min/m2 despite maximal inotropes. Their CAVH-D filters cleared a mean of 600 mL/h, but they required constant fluid resuscitation and died of cardiogenic shock and ARDS within 3 days. The other 11 patients had significant improvement in their respiratory function. Mean FI02 was weaned from 0.73 to 0.45 (p less than 0.005) and PEEP from 14.3 cm to 8.9 cm (p less than 0.005). Peak airway pressures fell from a mean of 60 mm Hg to 45 mm Hg (p less than 0.01). There was no significant change in CI or wedge pressure, but oxygen consumption rose from a mean of 279 to 409 mL/m (p less than 0.05). The technique of CAVH-D offers an alternative to patients with ARDS who do not have large on-going fluid requirements. It is safe, can be managed by the surgical staff, and is associated with a significant improvement in respiratory variables without requiring a drop in filling pressures that might potentially compromise oxygen transport.
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PMID:Continuous arteriovenous hemofiltration countercurrent dialysis (CAVH-D) in acute respiratory failure (ARDS). 192 May 60

Acute edematous pancreatitis was induced in rats by iv infusion of caerulein (CR) in a supramaximal dose of 7.5 x 10(-6)g x kg-1 x hr-1 during 6 hr. The most important finding of our study was the marked decrease of protein and nonprotein thiol content in pancreatic tissue of rats with CR-induced acute pancreatitis (AP). Oxygen radicals as well as 4-hydroxyalkenals resulting from lipid peroxidation are believed to be at least partly responsible for this phenomenon. Covalent binding of excessive amounts of 4-hydroxyalkenals to pancreatic tissue protein sulfhydryl groups has been documented. Presented data suggest a serious disturbance of sulfhydryl compounds metabolism in pancreatic tissue of rats with CR-induced AP which may be of importance in the pathogenesis of the disease.
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PMID:Products of lipid peroxidation and changes in sulfhydryl compounds in pancreatic tissue of rats with caerulein-induced acute pancreatitis. 193 Nov 50

The purpose of this study was to analyse the clinical course of 410 patients of severe surgical infections (primary 251, postoperative 159) during recent 5 years and to evaluate the important background factors which make these patients serious. As a result, the following patients such as, (1) who have refractory primary infections, for example malignant lymphoma, severe pancreatitis etc. (2) whose infectious foci were uncontrolled. (3) who had finally complicated a septic MOF or DIC, seemed to be especially critical even though recent advanced surgical therapy. To improve these severe conditions, we believe to need a renewed approach like so called "multi-disciplinary therapy", additionally with both conventional antibiotics administration and drainage for infectious foci. Several methods such as, (1) rational nutrition management using indirect calorimetry. (2) plasma exchange for removing toxic substances such as bacterial toxins, chemical mediators etc, from circulating blood. (3) pharmacological block of these toxic substances, were shown. In terms of the harmful chemical mediators, we supposed that both PAF (platelet activating factor) and oxygen free radical were extremely important in septic conditions from previous clinico-experimental studies. Therefore the effects of those pharmacological blockers such as PAF antagonists, SOD, protease inhibitor in experimental endotoxin shock were discussed in detail.
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PMID:[Clinico-experimental analysis of backgrounds of the severe surgical infections]. 194 10

Acute edematous pancreatitis was induced in Wistar male rats by iv infusion of cerulein (CR) in the dose of 5.10(-6)g.kg-1.h-1 during 3 or 6 h. The effect of BN 52021--platelet activating factor (PAF) receptor antagonist, against this model of disease was examined. BN 52021 was applied iv as a bolus injection in the dose of 5.10(-3)g.kg-1 at 0 time. Treatment with this agent significantly ameliorates cerulein-induced acute pancreatitis in rats. The effect of BN 52021 was expressed by significant reduction of pancreas edema, diminution of hyperamylasemia, lack of superoxide dismutase activity depletion, and inhibition of lipid peroxidation in pancreatic tissue. These changes were accompanied by significant reduction of acinar cells vacuolization and remarkable inhibition of infiltration with inflammatory cells in the interacinar space. We suppose that beneficial effect of BN 52021 against cerulein-induced acute pancreatitis in rats depends on the prevention of inflammatory cells activation and subsequent generation of oxygen radicals within pancreatic tissue.
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PMID:The effect of platelet activating factor antagonist (BN 52021) on cerulein-induced acute pancreatitis with reference to oxygen radicals. 203 14

Acute edematous and necrotic pancreatitis have been induced in dogs with retrogradely intraductal injections of 5% hydrogen peroxide solution and sunflower-oil. The process of disease could be followed daily by a zipper sutured into the abdominal wound. In this manner the temporal changes of markers of oxygen-derived free radicals (concentrations of malondialdehyde and reduced glutathione of the excised pancreas tissue and abdominal exudate, as well as the superoxide dismutase content of the tissue) could be controlled. Light microscopic analysis was also done. In edematous pancreatitis reversible membrane lesions, in the necrotic form the irreversible damage of membranes and cells could be seen. The results obtained suggest the role of oxygen-derived free radicals in experimental acute pancreatitis.
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PMID:Oxygen-derived free radical reactions in experimental acute pancreatitis of the dog. 209 70

Experiments were conducted to study the acid-base equilibrium of blood in pancreatitis and in combination with laser irradiation of venous blood by the intravascular method through a light guide. Irradiation of blood was attended by inhibition of metabolic acidosis development, which was evidently linked with improved blood oxygen transport function in response to exposure to the laser beam.
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PMID:[Changes in acid-base equilibrium of blood after intravenous laser irradiation (experimental study)]. 221 68

We investigated the impact of norepinephrine administration on hemodynamics, oxygen metabolism and renal function in patients in severe septic shock. PATIENTS AND METHODS. Twenty-six patients with extremely low resistance who were between 24 and 87 years of age were included in the study. In 7 patients, acute necrotizing pancreatitis and superinfection was diagnosed; 19 patients suffered from diffuse peritonitis. The entrance criteria for the study were: a mean arterial pressure (MAP) of below 60 torr or, in chronic hypertensive patients, a decrease in systolic pressure of more than 50 torr compared to previous values, despite volume optimization, and dopamine greater than 20 micrograms/kg per min and cumulative doses of dopamine/dobutamine greater than 30 micrograms/kg per min, respectively. Cases with tachycardia greater than 140/min were also included in the study even when the inotropic medication dose was lower. After registration of baseline values, dopamine was reduced to 2.5 micrograms/kg per min, and norepinephrine was administered starting at a dose rate of 0.05 micrograms/kg per min, until a MAP of greater than 60 torr could be maintained. RESULTS. Of the 26 patients investigated, 16 survived; 10 patients with persisting sepsis died due to multiple organ failure (mortality: 38.5%). During the study period, a norepinephrine dosage ranging between 0.1 and 2 micrograms/kg per min was necessary to stabilize the arterial pressure. The mean dose rate was 0.3 micrograms/kg per min. The mean arterial pressure and systemic vascular resistance index showed a statistically significant increase of 30 and 20%, respectively, just after 1 h and distinctly remained above the initial values in the further course. The cardiac index remained constant or increased slightly. After 24 h a statistically significant increase in stroke volume and a decrease in heart rate could be observed. Creatinine clearance increased significantly from the control value of 73 +/- 48 ml/min to 114 +/- 37 ml/min after 48 h under norepinephrine treatment. O2-delivery and O2-consumption did not change significantly, although they showed a slight tendency to increase. CONCLUSION. When patients are in a septic high output-low resistance condition, particular attention must be paid to maintaining sufficient mean arterial pressures. Our results suggest that this essential goal can be achieved by norepinephrine. The mean arterial pressure and glomerular filtration rate improved markedly, and there was no evidence of bad effects such as an increased afterload on critical parameters like cardiac index, O2-delivery and O2-consumption.
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PMID:[Noradrenaline in the "high output-low resistance" state of patients with abdominal sepsis]. 227 72

Acute edematous pancreatitis was induced in conscious rats by intravenous infusion of cerulein at a supramaximal dose of 7.5 micrograms/kg/h during 6 h. The most important finding of our study was a marked decrease in the protein and non-protein content of sulfhydryl groups parallel to an evident elevation in the malondialdehyde concentration in pancreatic tissue. The presented data suggest that in cerulein-induced acute pancreatitis in rats, oxygen radicals mediate increased peroxidation reactions which are accompanied by depletion of nonenzymatic sulfhydryl-containing free radical scavengers. The above phenomenon contributes to a disturbance in thiol metabolism resulting in serious diminution of pancreatic protein sulfhydryl compounds.
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PMID:Oxygen radicals mediate depletion of pancreatic sulfhydryl compounds in rats with cerulein-induced acute pancreatitis. 229 43

A dog model was used to measure the hemodynamic changes occurring during acute pancreatitis induced by intraductal injection of fresh trypsin-bile-blood mixture. Continuous measurements of pancreatic blood flow, cardiac output, mean arterial blood pressure and pancreatic oxygen consumption were made under normal conditions and during acute pancreatitis. All animals received 100 ml of saline/h during the time of observation. Three methods of therapy then were instituted in the dogs starting 30 min after induction of pancreatitis. 10 dogs served as controls (saline 100 ml/h); in 6 dogs additionally 15 ml/kg plasma was infused over 45 min and 6 dogs received 1.5 ml/kg Dextran 40/h continuously. Hemorrhagic pancreatitis was characterized by a fall in cardiac output and mean arterial pressure and the development of severe impairment of the pancreatic microcirculation with early reduction of pancreatic blood flow followed by a fall in pancreatic oxygen consumption. Administration of plasma produced a significant increase in cardiac output; however, blood pressure and pancreatic blood flow remained low. Low-molecular weight Dextran has no influence on cardiac output, but significantly improved the blood pressure and leads to a normalization in pancreatic blood flow and oxygen consumption. These results suggest that low-molecular weight Dextran appears to reverse the impairment of microcirculation and hypoxia of the pancreas and limits the progression from edematous to hemorrhagic pancreatitis and irreversible pancreatic damage.
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PMID:[Hemorrhagic pancreatitis: effect of dextran 40 and plasma on microcirculation disorders of the pancreas]. 241 Jul 52

The role of oxygen-derived free radicals in the pathogenesis of acute pancreatitis was studied by evaluating the effects of catalase, allopurinol, and dimethylsulfoxide on diet-induced acute hemorrhagic pancreatic necrosis in mice. The mortality rate and degree of hyperamylasemia associated with this model of pancreatitis were reduced by catalase but a similar result followed the administration of heat-denatured catalase, suggesting that the apparent protective effect of catalase was not the result of reductions in free radical levels. Neither allopurinol nor dimethylsulfoxide reduced mortality or degree of hyperamylasemia. The increased pancreatic content of amylase and the necrosis that characterize this model of pancreatitis were not altered by any of the agents tested. In contrast, both allopurinol and dimethylsulfoxide reduced peripancreatic edema formation, suggesting that edema, but not the other features that characterize this model of pancreatitis, may result from generation of oxygen-derived free radicals.
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PMID:Role of oxygen-derived free radicals in diet-induced hemorrhagic pancreatitis in mice. 243 85


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