Acute Pancreatitis, Complication of Ventilation Therapy
Conditions
Keywords
severe acute pancreatitis, mechanical ventilation
Brief summary
Acute lung injury (ALI) and acute respiratory distress syndrome(ARDS) represent the most common and earliest organ dysfunction in acute pancreatitis, presenting as dyspnea and intractable hypoxemia, with secondary bilateral pulmonary infiltrates on radiograph. And mechanical ventilation (MV) is the essential intervention to improve oxygenation. When to initiate MV remains uncertain. In this study, we aim to compare the effect of early MV and conventional MV, and we hypothesize that early MV may be a better treatment option.
Interventions
OTHERearly mechanical Ventilation
Fulfillment of three or more criteria below: respiratory rate \> 28 per minute serum lactate \> 3 mmol/L PaO2/FiO2 Index \<300 mmHg SvO2 \< 65% lung infiltration or atelectasis, pleural exudation
other group who don't start early mechanical ventilation and fulfillment four criteria below: respiratory rate \> 28 bpm dyspnea PaO2/FiO2 Index \<200 mmHg Chest X-ray: lung infiltration exclude chronic heart failure and pulmonary disease
Sponsors
Ruijin Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of pancreatitis:typical pain, increase in serum lipase or amylase, onset of abdominal pain within 72h before admission * The diagnosis criteria of Severe Acute Pancreatitis is according to Atlanta criteria revisited in 2012 * the diagnosis of ARDS meets the criteria of Berlin definition
Exclusion criteria
* chronic respiratory disease as chronic obstructive pulmonary disease (COPD), asthma * organic cardiopathy * pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mechanical Ventilation Time | 28 days |
Secondary
| Measure | Time frame |
|---|---|
| the incidence of ventilation associated pneumonia | 28 days |
Other
| Measure | Time frame | Description |
|---|---|---|
| mortality | 60 days | — |
| the incidence other complications of mechanical ventilation | participants will be followed for the duration of hospital stay, an expected average of 2 months | patient-mechanic desynchronization, pneumothorax, atelectasis |
| hospital stay | the participants will be followed till the discharge, an expected average of 2 months | — |
Countries
China
Contacts
Primary ContactErzhen CHEN, MD
Backup ContactEnqiang MAO, MD
Outcome results
None listed