Severe acute pancreatitis
Conditions
Interventions
Fluid resuscitation via colon group:Fluid resuscitation via colon
Intravenous fluid resuscitation group:Intravenous fluid resuscitation
Sponsors
Ruijin hospital, Shanghai Jiao Tong University School of Medicine
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1) First onset of illness, admitted within 72 hours after onset. 2) Diagnosed with acute pancreatitis within 24 hours of admission: upper abdominal pain; plasma amylase level elevated more than 3 times the upper limit of normal; imaging evidence of acute pancreatitis. Meet 2 or more of the following criteria. 3) Moderate-severe acute pancreatitis: clinical manifestations and biochemical changes of acute pancreatitis, accompanied by transient organ failure (Modified Marshall score = 2 points, recoverable within 48 hours), or accompanied by local or systemic complications. Severe acute pancreatitis: clinical manifestations and biochemical changes of acute pancreatitis, accompanied by persistent (>48 hours) organ dysfunction, Modified Marshall score = 2 points. 4) Age = 18 years, = 75 years. 5) Meet 2 or more of the following criteria: heart rate = 120 bpm; MAP 85 mmHg; urine output = 0.5 ml/kg/h; HCT > 44%. 6) Informed consent has been obtained.
Exclusion criteria
Exclusion criteria: Subjects meeting any of the following criteria will be excluded from this study: 1) Previous episodes of pancreatitis or a history of chronic pancreatitis. 2) Diagnosis of pancreatitis more than 24 hours after admission or admission more than 72 hours after the onset of symptoms. 3) Pancreatitis caused by malignant tumors or ERCP. 4) Pregnancy or lactation. 5) Patients or their proxies refusing active organ support measures such as renal replacement therapy, vasopressor medications, and mechanical ventilation. 6) Pre-existing chronic organ failure in the heart, liver, lungs, or kidneys; long-term use of left ventricular assist devices or potent cardiac drugs like milrinone; Child-Pugh class C or D liver function; chronic respiratory failure requiring long-term home non-invasive oxygen therapy (nasal cannula or non-invasive positive pressure ventilator); diagnosed chronic kidney disease with a sustained eGFR 150 umol/L. 7) Use of immunosuppressive agents or corticosteroids exceeding two weeks (equivalent to prednisone or methylprednisolone at a dose of 0.5 mg/kg/day), including various autoimmune diseases and organ transplantation. 8) Patient and family refusal to sign the informed consent form.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 28-day mortality; | — |
Secondary
| Measure | Time frame |
|---|---|
| Heart rate;blood pressure;urine volume;Intake and exit volume;intra-abdominal pressure;blood routine;electrolyte;lactic acid;hematocrit;Liver function;kidney function;Myocardial zymogram;arterial blood gas analysis;Coagulation function indicators;immune indicators;C-reactive protein;Procalcitonin;Stool routine;Urine routine; | — |
Countries
China
Contacts
Public ContactTongtian Ni
Ruijin hospital, Shanghai Jiao Tong University School of Medicine
Outcome results
None listed