Abstract
Study objective: to improve treatment results of patients with AP complicated by DT by early concomitant use of artificial lung ventilation (ALV) and detoxification by plasmapheresis. Methods of study and treatment. 146 patients with chronic alcoholic intoxication (CAI) and AP development complicated by DT were enrolled to the study. Patients of Group I (reference group, n=45) received «standard» therapy. Group II included patients who received extracorporeal detoxification by plasmapheresis in addition to «standard» therapy (n=51). Group III included patients who underwent oxygenation correction by ALV in addition to «standard» therapy and extracorporeal detoxification by plasmapheresis (n=50). Results. During the evaluation of plasmapheresis efficacy, more rapid normalization of blood biochemistry in patients from Group II was noticed. The following parameters were decreased: blood α#amylase by 73.2%, bilirubin level by 33.3%, AST by 34.1%, ALT by 17.7%; arterial blood lactate level was normalized by 47.6% on Day 3 vs. Group I (p<0.05). 17.7% patients (n=8) in Group I and 17.6% patients (n=9) in Group II received respiratory support by ALV at different time points due to severe hypoxia. Concomitant use of exogenous detoxification by plasmapheresis and early ALV in patients with AP complicated by DT decreased delirium duration from 5.4±0.2 days (Group I) and 4.1±0.2 days (Group II) to 1.1±0.1 days in Group III patients. In patients of the Group III no cases of self-aggression were reported. No significant differences were observed between Group I and Group II. Conclusion. Concomitant use of exogenous detoxification by plasmapheresis and early extended ALV during complex therapy of patients with AP complicated by DT improves blood biochemical parameters and decreases delirium duration and in-patient duration of treatment. Medication sedative therapy with extended ALV levels abrogates the development of a self-aggression.
Highlights
В последние годы заболеваемость алкого лизмом, не снижается, а наоборот растет [1, 6]
The work was based on evaluation and treatment of 146 patients with chronic alcoholic intoxication and acute alco holic edematous pancreatitis complicated by delirium tremens admitted to anesthesiology and intensive care department
In Group II, sedation (midazolam (Fulsed) 5 mg/mL at the dose of 0.14 mg/kg i.v., droperidol 2.5 mg/mL at the dose of 0.22 mg/kg i.m.) didn't give necessary effect: 43% patients (n=22) fell asleep ini tially but became agitated during plasmapheresis (+3 according to RASS), 25% patients (n=13) remained to be slightly obtunded ( 1 according to RASS) but continued to «hinder» plasmapheresis
Summary
В последние годы заболеваемость алкого лизмом, не снижается, а наоборот растет [1, 6]. Вызванные употреблением алкоголя, составили в 2015 году около 82% всех официаль но зарегистрированных случаев наркологических заболеваний в Российской Федерации. Из них почти 90% составляют лица трудоспособного воз раста — от 20 до 59 лет [5]. Острый панкреатит является полиэтиологи ческим заболеванием и прочно удерживает 3 е место среди всех острых хирургических заболева ний органов брюшной полости [11, 12]. В России наиболее часто (45%) его развитие связано с забо леванием внепеченочных желчных путей и алко гольной интоксикацией (35%) [11, 14]. Тяжесть течения панкреатита делает его ярко выражен ным примером критического состояния [7, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
