Krauss, Lea U. and Brosig, Andreas-M. and Schlosser, Sophie and Pavel, Vlad and Mehrl, Alexander and Guelow, Karsten and Kandulski, Arne and Mueller, Martina and Schmid, Stephan (2023) Therapeutic Plasma Exchange in ICU patients with acute hypertriglyceridemia-induced pancreatitis improves patient outcomes. DIGESTIVE DISEASES, 41 (4). pp. 647-655. ISSN 0257-2753, 1421-9875
Full text not available from this repository. (Request a copy)Abstract
Background: Acute severe pancreatitis is associated with high morbidity and mortality. Hypertriglyceridemia is the third most common cause of acute pancreatitis and higher triglyceride levels increase the risk for severe acute pancreatitis. Plasma exchange is an effective treatment method to lower triglycerides. Our study aimed to investigate the efficiency of plasma exchange as a treatment option for acute hypertriglyceridemia-induced pancreatitis (HTGP), the impact on mortality assessed by the SOFA-, SAPS II-, BISAP Score, Ranson's, and Glasgow-Imrie Criteria as well as the overall length of stay in hospital and ICU.Methods: In this retrospective single-center cohort study, triglycerides before and after plasma exchange were compared. SOFA and SAPS II were taken on ICU admission and at discharge. To further characterize the patient cohort, BISAP Score (on admission), Ranson's Criteria (on admission and after 48 hours), and the Glasgow-Imrie Criteria (48 hours after admission) were calculated.Results: The study included 11 patients (91 % male; median age 45 years). Triglycerides were reduced from 4266 +/- 3560.6 to 842 +/- 575.9 mg/dl during plasmapheresis (P < .001). The median ICU length of stay was 3 +/- 4.2 days. In-hospital mortality was 0 %. The SOFA score was significantly reduced from 4 +/- 3.4 points on admission to 2 +/- 2.1 points at discharge (P = .017). Triglycerides and cholesterol decreased from 3126 +/- 3665 to 531 +/- 273 mg/dl (P = .003) and from 438 +/- 137.9 to 222 +/- 59.5 mg/dl (P = .028), respectively. Conclusion: Plasmapheresis is an efficient and safe treatment method for ICU patients with acute HTGP and significantly reduces triglycerides. Furthermore, plasmapheresis significantly improves the clinical outcomes of patients with HTGP.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | C-REACTIVE PROTEIN; PERSISTENT ORGAN FAILURE; CRITICALLY-ILL PATIENTS; HYPERLIPIDEMIC PANCREATITIS; PROGNOSTIC ACCURACY; EARLY PREDICTION; IONIZED CALCIUM; SERUM-CALCIUM; APACHE-II; MORTALITY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Mar 2024 13:39 |
| Last Modified: | 09 Mar 2024 13:39 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59382 |
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