Resuscitation as a mandatory preliminary stage in the treatment of patients with severe necrotizing pancreatitis in the early stages of the disease

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The presented review helps to explain the mechanisms of the development of destructive pancreatitis. The research is based on the analysis of domestic and foreign literature. It was found confirmation of the presence of mechanisms of microcirculatory disorders, the basis of which is the development of cellular and tissue ischemia, initiated by cytokine intercellular interactions, ultimately leading to multiple organ failure. The universality of the mechanism of development of the described pathophysiological phenomenon is the body’s response to super aggression, developed in the process of evolution and genetically encoded in the chronobiological program of the living system. Critical conditions, different in etiological characteristics, are a monopathogenetic process, the biological expediency of which is built on the criteria of «economy», simplicity and efficiency. The applied value of the obtained results lies in the fact that they create the basis for building the pathogenetic treatment of patients with critical conditions, which are correlated to the clinical equivalents of the pathophysiological phenomenon in the form of microcirculation disorders of organs and tissues.

About the authors

B. B. Bromberg

The N.I.Pirogov National Medical and Surgical Center of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: trebleb82@mail.ru

кандидат медицинских наук

Russian Federation, Moscow

P. E. Krainyukov

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation; Russian Peoples’ Friendship University of the Ministry of Education and Science of the Russian Federation

Email: trebleb82@mail.ru

доктор медицинских наук, доцент, генерал-майор медицинской службы

Russian Federation, Moscow; Moscow

A. V. Denisov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: trebleb82@mail.ru

кандидат медицинских наук, подполковник медицинской службы

Russian Federation, St. Petersburg

V. V. Kokorin

The N.I.Pirogov National Medical and Surgical Center of the Ministry of Health of the Russian Federation; The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: kokorinvv@yandex.ru

кандидат медицинских наук, подполковник медицинской службы

Russian Federation, Moscow; Moscow

M. V. Grinev

The I.I.Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine

Email: trebleb82@mail.ru

профессор

Russian Federation, St. Petersburg

References

  1. Бойко В.В., Криворучко И.А., Шевченко Р.С. и др. Острый панкреатит. – Харьков: Торнадо, 2002. – 288 с.
  2. Выренков Ю.Е., Есипов А.В., Москаленко В.И., Гурьев Г.С. Эндолимфатическая профилактика гнойно-септических осложнений у хирургических больных // Вестн. лимфологии. – 2009. – № 4. – С. 43–47.
  3. Гринев М.В., Гринев К.М. Некротический фасциит. – СПб: Гиппократ, 2003. – 117 с.
  4. Гринев М.В., Громов М.И., Комраков В.Е. Хирургический сепсис. – СПб; М., 2001. – 315 с.
  5. Есипов А.В., Мусаилов В.А., Шишло В.К. Исследование уровня гистамина в перитонеальной жидкости при перитоните // Воен.-мед. журн. – 2016. – Т. 337, № 4. – С. 58–59.
  6. Зильбер А.П. Этюды критической медицины. – М.: Медпресс-Информ, 2006. – 565 с.
  7. Колесников В.В. Тромбопластиновая коагулопатия у больных с политравмой // Хирургия. – 2002. – № 9. – С. 41–44.
  8. Лобанова Т.Н., Шарапов Г.Н., Есипов А.В., Павлова М.В., Алехнович А.В. Современная лабораторная диагностика нарушений гемостаза в клинической практике многопрофильного госпиталя // Госпит. медиц.: наука и практика. – 2020. – Т. 1, № 4. – С. 54–64.
  9. Мусаилов В.А., Крайнюков П.Е., Есипов А.В., Лазарев А.Б. К лечению перитонита, вызванного патологией верхних отделов мочевыделительной системы // Воен.-мед. журн. – 2018. – Т. 339, № 4. – С. 19–24.
  10. Топузов Э., Галиев Ш.И., Рубцов И.А. и др. Фулминантный (молниеносный, быстротечный, мгновенный) острый панкреатит. Существуют ли объективные критерии такого диагноза? // Вестн. хир. – 2012. – № 4. – С. 28–32.
  11. Чернух А.М., Алекперов П.Н. Микроциркуляция. – М.: Медицина, 1975. – 455 с.
  12. Baillargeon J.D., Orav J., Ramagopal V. et al. Hemoconcentration as an early risk factor for necrotizing pancreatitis // Am. J. Gastroenterol. – 1998. – Vol. 93. – P. 2130–2134.
  13. Banks P.A., Freeman M.L. Practice guidelines in acute pancreatitis // Am. J. Gastroenterol. – 2006. – Vol. 101. – P. 2379–2400.
  14. Baron T.H., Morgan D.E. Acute necrotizing pancreatitis // N. Engl. J. Med. – 1999. – Vol. 340. – P. 1412–1417.
  15. Bone R.C., Balk R.A., Carra F.B. Definitions for sepsis and organ failure and guidelines committee // Chest. – 1992. – Vol. 101. – P. 1664–1655.
  16. DeFrances C.J., Hall M.J., Podgornik M.N. National Hospital Discharge Survey: advance data from vital and health statistics. – Hyattsville: National Center for Health Statistics, 2005. – 359 p.
  17. Eckerwall G., Olin H., Andersson B., Andersson R. Fluid resuscitation and nutritional support during severe acute pancreatitis in the past: what have we learned and how can we do better? // Clin. Nutr. – 2006. – Vol. 25. – P. 497–504.
  18. Forsmark C.E., Gardner T.B. Prediction and Management of Severe Acute Pancreatitis. – New York: Springer Science+Business Media, 2015. – P. 101–113. doi: 10.1007/978-1-4939-0971-1_5
  19. Freitag M., Standl T.G., Kleinhans H. et al. Improvement of impaired microcirculation and tissue oxygenation by hemodilution with hydroxyethyl starch plus cell-free hemoglobin in acute porcine pancreatitis // Pancreatol. – 2006. – Vol. 6. – P. 232–239.
  20. Gan S.I., Romagnuolo J. Admission hematocrit: a simple, useful and early predictor of severe pancreatitis // Dig. Dis. Sci. – 2004. – Vol. 49. – P. 1946–1952.
  21. Gardner T.B., Vege S.S., Chari S.T. et al. Faster rate of initial fluid resuscitation in severe acute pancreatitis diminishes in-hospital mortality // Pancreatology. – 2009. – Vol. 9. – P. 770–776.
  22. Grinev M.V., Kulibaba D.M., Medvedev V.G. et al. The role of cytokines in the pathogentsis of the peritonitis complicated by septic shock / 2nd Europ. Congr. of Trauma and Emerg. Surg. (1997), Athens, Greece // Europ. G. Emerg. Intens. Care. – 1997. – Vol. 27. – P. 161–165.
  23. Hardaway R. Disseminated intravascular coagulation with special raference to shock and its treatment // Mil. Med. – 1965. – Vol. 130. – P. 451–460.
  24. Juvonen P.O., Tenhunen J.J., Heino A.A. et al. Splanchnic tissue perfusion in acute experimental pancreatitis // Scand. J. Gastroenterol. – 1999. – Vol. 34. – P. 308–314.
  25. Klar E., Schratt W., Foitzik T. et al. Impact of microcirculatory flow pattern changes on the development of acute edematous and necrotizing pancreatitis in rabbit pancreas // Dig. Dis. Sci. – 1994. – Vol. 39. – P. 2639–2644.
  26. Knol J.A., Inman M.G., Strodel W.E., Eckhauser F.E. Pancreatic response to crystalloid resuscitation in experimental pancreatitis // J. Surg. Res. – 1987. – Vol. 43. – P. 387–392.
  27. Madaria E., Soler-Sala G., Sаnchez-Payа J. et al. Influence of fluid therapy on the prognosis of acute pancreatitis: a prospective cohort study // Am. J. Gastroenterol. – 2011. – Vol. 106, N 10. – P. 1843–1850.
  28. Mann D.V., Hershman M.J., Hittinger R., Glazer G. Multicentre audit of death from acute pancreatitis // Br. J. Surg. – 1984. – Vol. 81. – P. 890–893.
  29. Mao E.Q., Tang Y.Q., Li L. et al. Strategy of controlling fluid resuscitation for severe acute pancreatitis in acute phase // Zhonghua Wai Ke Za Zhi. – 2007. – Vol. 45. – P. 1331–1334.
  30. Morimoto T., Noguchi Y., Sakai T. et al. Acute pancreatitis and the role of histamine-2 receptor antagonists: a meta-analysis of randomized controlled trials of cimetidine // Eur. J. Gastroenterol. Hepatol. – 2002. – Vol. 14. – P. 679–686.
  31. National Center for Health Statistics. National hospital discharge summary: annual summary 1998; series report 13:203.
  32. Neoptolemos J.P., Raraty M., Finch M., Sutton R. Acute pancreatitis: the substantial human and financial costs // Gut. – 1998. – Vol. 42. – P. 886–891.
  33. Niederau C., Crass R.A., Silver G. et al. Therapeutic regimens in acute experimental hemorrhagic pancreatitis. Effects of hydration, oxygenation, peritoneal lavage, and a potent protease inhibitor // Gastroenterol. – 1988. – Vol. 95. – P. 1648–1657.
  34. Pandol S.J., Saluja A.K., Imrie C.W., Banks P.A. Acute pancreatitis: bench to the bedside //Gastroenterol. – 2007. – Vol. 132. – P. 1127–1151.
  35. Ranson J.H., Lakher J., Bernan J.P. The relationship coagulation factors to klinical complication of acute pancreatitis // Surgery. – 1977. – Vol. 812. – P. 502–511.
  36. Rau B., Poch B., Gansauge F. et al. Pathophysiologic role of oxygen free radicals in acute pancreatitis: initiating event or mediator of tissue damage? // Ann. Surg. – 2000. – Vol. 231. – P. 352–360.
  37. Sampath K., Gardner T.B. Fluid Resuscitation in Acute Pancreatitis / In: Prediction and Management of Severe Acute Pancreatitis. – New York: Springer Science+Business Media, 2015. – P. 101–113. doi: 10.1007/978-1-4939- 0971-1_5.
  38. Schoenberg M.H., Buchler M.W., Younes M. et al. Effect of antioxidant treatment in rats with acute hemorrhagic pancreatitis // Dig. Dis. Sci. – 1994. – Vol. 39. – P. 1034–1040.
  39. Takeda K., Mikami Y., Fukuyama S. et al. Pancreatic ischemia associated with vasospasm in the early phase of human acute necrotizing pancreatitis // Pancreas. – 2005. – Vol. 30. – P. 40–49.
  40. Talukdar R., Vege S. Early management of severe acute pancreatitis // Curr. Gastroenterol. Rep. – 2011. – Vol. 13, N 2. – P. 123–130.
  41. Tenner S., Baillie J., DeWitt J., Vege S.S. American College of Gastroenterology. American college of gastroenterology guideline: management of acute pancreatitis // Am. J. Gastroenterol. – 2013. – Vol. 108. – P. 1400–1415.
  42. Toyama M.T., Lewis M.P., Kusske A.M. et al. Ischaemia-reperfusion mechanisms in acute pancreatitis // Scand. J. Gastroenterol. Suppl. – 1996. – Vol. 219. – P. 20–23.
  43. Vege S.S., Chari S.T., Clain J.E. Severe acute pancreatitis // JAMA. – 2004. – Vol. 291. – P. 2865–2868.
  44. Wall I., Badalov N., Baradarian R. et al. Decreased mortality in acute pancreatitis related to early aggressive hydration // Pancreas. – 2011. – Vol. 30. – P. 547–550.
  45. Wang Z.F., Liu C., Lu Y. et al. Dexamethasone and dextran 40 treatment of 32 patients with severe acute pancreatitis // World J. Gastroenterol. – 2004. – Vol. 10, N 9. – P. 1333–1336.
  46. Warndorf M.G., Kurtzman J.T., Bartel M.J. et al. Early fluid resuscitation reduces morbidity among patients with acute pancreatitis // Clin. Gastroenterol. Hepatol. – 2011. – Vol. 9, N 8. – P. 705–709.
  47. Whitcomb D.C. Clinical practice: acute pancreatitis // N. Engl. J. Med. – 2006. – Vol. 354. – P. 2142–2150.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2022 Bromberg B.B., Krainyukov P.E., Denisov A.V., Kokorin V.V., Grinev M.V.


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.