ArticleIntensive care medicine2013
The impact of early goal-directed fluid management on survival in an experimental model of severe acute pancreatitis.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 42 citations in OpenAlex.
- Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial.Critical care (London, England) · 2013Trial
- Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review.Annals of intensive care · 2022Review
- The use of pulse pressure variation for predicting impairment of microcirculatory blood flow.Scientific reports · 2021Article
- [Treatment of acute necrotizing pancreatitis].Der Internist · 2019Review
- Mandatory criteria for the application of variability-based parameters of fluid responsiveness: a prospective study in different groups of ICU patients.Journal of Zhejiang University. Science. B · 2018Article
- What's new in the management of severe acute pancreatitis?Intensive care medicine · 2015Article
- Early peritoneal lavage with ulinastatin improves outcome and enhances multi-organ protection in a model of severe acute pancreatitis.Experimental and therapeutic medicine · 2015Article
- Fluid resuscitation in acute pancreatitis.World journal of gastroenterology · 2014Review
- New tools for optimizing fluid resuscitation in acute pancreatitis.World journal of gastroenterology · 2014Review
- Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?Pancreas · 2014Article
- Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition.Intensive care medicine · 2014Article
- Goal-directed fluid resuscitation in acute pancreatitis: shedding light on the penumbra by dynamic markers of preload?Intensive care medicine · 2013Article
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Authors and funding
10 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeSevere acute pancreatitis (SAP) remains a life-threatening disease with classic etiology of systemic inflammatory response and mortality between 30 and 50 %. The aim of the present study is to compare two different treatment strategies of goal-directed hemodynamic management and evaluate their impact on survival, microcirculation, tissue oxygenation, and histopathologic damage in acute pancreatitis in a prospective animal study.
methodsThirty-four domestic pigs were randomly assigned to two different treatment groups. After induction of acute pancreatitis, in group 1 volume administration was guided by central venous pressure (CVP >12 mmHg) and mean arterial pressure (MAP). In group 2, hemodynamic management was guided primarily by left-ventricular stroke volume variation (SVV <10 %), MAP, and cardiac output (CO). Treatment according to randomization was performed for 6 h, and tissue oxygen tension in the pancreas and pancreatic microcirculation were evaluated. Thereafter, animals were observed for 7 days and then sacrificed. Standardized tissue specimens were taken post mortem, and histopathologic scoring was performed.
resultsSurvival after 7 days was 29.4 % in group 2 versus 11.8 % in group 1 (p < 0.05). Pancreatic oxygen tension (138.0 ± 89.5 mmHg versus 71.1 ± 35.3 mmHg; p < 0.05) and pancreatic microcirculation (1,209.9 ± 630 AU versus 732 ± 315 AU; p < 0.05) were significantly higher in group 2. Significantly less histopathologic damage within the pancreas could be analyzed post mortem in group 2.
conclusionsGoal-directed hemodynamic management guided by stroke volume variation led to improved survival, tissue oxygenation, and microcirculatory perfusion, as well as less histopathologic damage in an animal model of severe acute pancreatitis.
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