Beneficial effects of fluid resuscitation via the rectum on hemodynamic disorders and multiple organ injuries in an experimental severe acute pancreatitis model

Chen, Ying; Ma, L i; Song, Xiaolong; Fei, Jian; Chen, Erzhen; Mao, Enqiang

doi:10.1016/j.pan.2015.09.001

Cited by 12 publications

(14 citation statements)

References 36 publications

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“…The present study demonstrated that aggressive intravenous hydration with LRS (3 mL/kg/h during and for 8 hours after the ERCP, with a 20 mL/kg bolus immediately after the ERCP) decreased the risk of PEP compared with standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after the ERCP). One study in an experimental severe acute pancreatitis model suggested that intravenous fluid resuscitation at a rate of 4 mL/kg/h reversed the decline of mean arterial pressure [22]. According to the 2012 International Association of Pancreatology/the American Pancreatic Association guidelines, ▶ Table 1 Baseline characteristics of the 395 patients who were randomized to aggressive or standard hydration with lactated Ringer's solution (LRS) goal-directed intravenous fluid therapy with 5 -10 mL/kg/h should be used initially for the management of acute pancreatitis [23].…”

Section: Discussionmentioning

confidence: 99%

Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial

et al. 2017

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Background and study aims The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Patients and methods In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer’s solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after ERCP). The primary end point was post-ERCP pancreatitis (PEP). Results 395 patients were enrolled, and 385 completed the protocols. The three groups showed no significant differences in demographic characteristics. There was a significant difference in the intention-to-treat (ITT) PEP rate between the aggressive LRS group (3.0 %, 95 % confidence interval [CI] 0.1 % – 5.9 %; 4 /132), the aggressive NSS group (6.7 %, 95 %CI 2.5 % – 10.9 %; 9 /134) and the standard LRS group (11.6 %, 95 %CI 6.1 % – 17.2 %; 15 /129; P = 0.03). In the two-group comparisons, the ITT PEP rate was significantly lower for the aggressive LRS group than for the standard LRS group (relative risk [RR] 0.26, 95 %CI 0.08 – 0.76; P = 0.008). There was no significant difference in the ITT PEP rate between the aggressive NSS group and the standard LRS group (RR 0.57, 95 %CI 0.26 – 1.27; P = 0.17). Conclusion Aggressive hydration with LRS is the best approach to intravenous hydration for the prevention of PEP in average-to-high risk patients.

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Section: Discussionmentioning

confidence: 99%

Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial

et al. 2017

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“…The most effective treatment is fluid resuscitation, which is recognized as the primary measure in the current guidelines (2,16). Chen et al (5), demonstrated that FRVR is a potential supplementary method for fluid management at the early stages of SAP. Following treatment with FRVR, the MAP and organ function improved, suggesting that the colon may readily absorb a large volume of water under conditions of shock.…”

Section: Discussionmentioning

confidence: 99%

“…SAP model establishment and fluid resuscitation. The SAP model was established as previously described (5). The rats were fasted overnight with free access to water prior to the experiment, and were randomly divided into four groups as follows: The SHAM, no fluid resuscitation (NFR), intravenous fluid resuscitation (IVFR) and fluid resuscitation via the rectum (FRVR) groups.…”

Section: Methodsmentioning

confidence: 99%

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Fluid resuscitation via the rectum ameliorates hemodynamic disorders through adjusting aquaporin expression in an experimental severe acute pancreatitis model

et al. 2018

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Acute pancreatitis is an acute abdominal disease, with 10-20% of the cases deteriorating rapidly, accompanied by persistent organ failure and further development into severe acute pancreatitis (SAP). The aim of the present study was to investigate the mechanism of fluid resuscitation via the rectum in the early stages of SAP and the role of aquaporins (AQPs). An SAP model was constructed by injection of 5% sterile sodium taurocholate into the biliopancreatic duct of Sprague Dawley rats, and the mean arterial pressure (MAP) was continuously monitored via femoral artery catheterization. At 30 min after the construction of the SAP model, the rats in the fluid resuscitation groups were resuscitated with normal saline at a rate of 4 ml/kg/h through the venous or the rectal route. The AQP and Na + -K + -ATPase levels, and the correlation of the MAP and colon AQPs at the early stages of SAP were analyzed. The results demonstrated that the mRNA level of AQP-3 and AQP-4 in the distal colon decreased significantly in the group subjected to fluid resuscitation via the rectum, while no significant differences were identified in the Na + -K + -ATPase levels of the colon in that group. Furthermore, a negative correlation was identified between the expression of AQPs and the MAP (P<0.01). Thus, fluid resuscitation via the rectum appears to ameliorate hemodynamic disorders through adjusting the expression of AQP-3 and AQP-4 in the distal colon in an experimental SAP model.

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“…qd.) and unfractionated heparin (3-15 IU/kg an hour) are recommended for anticoagulation, or intermittent short veno-venuous hemofiltration is given [130,131].…”

Section: Other Treatment Measuresmentioning

confidence: 99%

Medication therapy strategies for the coronavirus disease 2019 (COVID-19): recent progress and challenges

Yang

Liu

et al. 2020

Expert Review of Clinical Pharmacology

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has spread globally since it outbroke in December 2019. The urgent pandemic presents an unprecedented challenge to develop and identify effective medication therapy strategies to combat the COVID-19. Areas covered: Here, we summarized and evaluated the current treatment drugs and regimens, and put forward the treatment recommendations, including using the potential repurposed or experimental drugs against COVID-19, e.g. chloroquine (CQ), hydroxychloroquine (HCQ), lopinavir/ritonavir (LPV/r), remdesivir (RDV), and favipiravir (FPV). We also analyzed the specific drugs and vaccines against SARS-CoV-2 ongoing development and formulated the comprehensive treatment regimens based on condition of patients, diseases and drugs as well as concomitant medications. Expert opinion: No drugs and vaccines have been proven to be particularly effective against SARS-CoV-2 up to now. The recommended comprehensive medication therapy strategies have already displayed favorable effect in the fight against COVID-19. Research should be focused on the development of anti-SARS-CoV-2 drugs and vaccines based on high-quality clinical trial evidence, treatment guidelines and expert consensus.

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Beneficial effects of fluid resuscitation via the rectum on hemodynamic disorders and multiple organ injuries in an experimental severe acute pancreatitis model

Cited by 12 publications

References 36 publications

Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial

Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial

Fluid resuscitation via the rectum ameliorates hemodynamic disorders through adjusting aquaporin expression in an experimental severe acute pancreatitis model

Medication therapy strategies for the coronavirus disease 2019 (COVID-19): recent progress and challenges

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