Health Condition 1: K852- Alcohol induced acute pancreatitis
Conditions
Interventions
Intervention1: Enhanced recovery in Acute Pancreatitis: Patients assigned to the enhanced recovery protocol will be immediately allowed a low-fat, solid diet. They will be started on lactated Ringers
however, if not, they will be transitioned to a rate of 1 mL/kg/h until tolerating diet or discontinued by the primary medical team. Patients will be started on paracetamol intravenous infusion 1g eve
ketorolac 30 mg) and severe pain (numeric rating, 7â??10
morphine 5 mg). Early ambulation will be encouraged for these patients
nursing orders will be placed for the patients to be out of bed on day of hospital admission, followed by ambulation 5 times a day with nursing assistance the subsequent hospital days.
Control Interve
Sponsors
JIPMER
Eligibility
Inclusion criteria
Inclusion criteria: • All Patients 18 years or older admitted with a diagnosis of acute pancreatitis without evidence of organ failure at admission and require more than 24 hours of hospital stay, will be eligible for study participation. Diagnosis will be confirmed by the presence of 2 or more of the following criteria: - Epigastric abdominal pain with or without radiating to the back, - Elevation in serum lipase and/or amylase greater than 3 times the upper limit of normal - Confirmatory findings of acute pancreatitis on cross-sectional imaging or abdominal ultrasound.
Exclusion criteria
Exclusion criteria: • Uncontrolled cardiac/ pulmonary / metabolic comorbidities • Pancreatitis in patients with hepatobiliary malignancy • Patients with Pre-existing liver dysfunction • Acute on chronic pancreatitis. • Moderately severe pancreatitis with evidence of organ failure at admission. ( organ failure defined as failure of Renal and/or Hepatic and/or pulmonary and/or cardiac systems) • Severe pancreatitis(defined as per modified ATLANTA criteria 2012. Any case of acute pancreatitis with persistent organ failure of more than 24 hours.)6 • Traumatic/post ERCP pancreatitis • Pancreatitis with medical history of immune disease • Diagnosis of acute pancreatitis first made at operation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| a)Time to successful oral refeeding within 24 hours of admission (It will be performed prospectively by the blinded study assessor through administration of daily questionnaires in which patients were asked to rate their pain control, diet intake, and degree of ongoing gastrointestinal symptoms) b)Length of hospitalization measured from the time of admission to the time decision taken for discharge Timepoint: baseline 24 hours | — |
Secondary
| Measure | Time frame |
|---|---|
| a)30 day readmission rate. b)Duration of IV fluid supplementation (measured by the volume of fluid support provided to the patients in both groups from admission till discharge) c)Mean pain scores and morphine equivalents will be compared during the recovery period of 48 to 72 hours d)Patient satisfaction (measured by 5 point likert scale at discharge and at 30 days) e)Pancreatitis activity scoring system at 48 and 72hrsTimepoint: 1. 30 day readmission rate 2. pain scores at 48 to 72 hours 3. PASS scoring at admission and discharge | — |
Countries
India
Contacts
Public ContactHosanna Singh Sati Raju CH
Jawaharlal Institute of post graduate medical education and research
Outcome results
None listed