Management of Acute Severe Hyperlipidemic Pancreatitis

Kyriakidis, A; Raitsiou, Bogdan; Sakagianni, Aikaterini; Harisopoulou, V.; Pyrgioti, M.; Panagopoulou, Alkioni; Vasilakis, Nikos; Lambropoulos, S.

doi:10.1159/000095425

Cited by 94 publications

(80 citation statements)

References 52 publications

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“…Several reports [25][26][27][28][29] document the successful use of TPE in treatment of hypertriglyceridemia. In some instances, TPE for hypertriglyceridemic pancreatitis resulted in improvements in clinical and laboratory findings and patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Plasmapheresis in the Management of Severe Hypertriglyceridemia

Seda

Meyer

Amundson

et al. 2013

Critical Care Nurse

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P lasmapheresis is an advanced and established extracorporeal therapy in critical care, a process in which plasma, the fluid part of the blood, is separated from blood cells by a device known as a cell separator. In critically ill patients, plasmapheresis is used to remove toxins, medications, destructive antibodies, and clotting factors from the peripheral circulation. During plasmapheresis, a nurse uses a cell separator that either spins the blood to separate the cells from the fluid or filters the blood through a membrane with extremely small pores that allow only the fluid part to pass through. Although in current practice the terms plasmapheresis and therapeutic plasma exchange (TPE) are often used interchangeably, TPE This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Describe use of plasmapheresis for the management of severe hypertriglyceridemia 2. Identify conventional therapeutic modalities used for management of hypertriglyceridemia 3. Discuss effects of hypertriglyceridemia on clinical laboratory tests CNE Continuing Nursing Education CoverPlasmapheresis can benefit a variety of critically ill patients. A woman with diabetic ketoacidosis and severe hypertriglyceridemia was treated with plasmapheresis when conventional treatments did not markedly reduce her triglyceridemia. The patient was admitted to a medical intensive care unit because of diabetic ketoacidosis with severe lipemia. The lipemia-associated interference in laboratory studies made treatment of electrolyte abnormalities extremely difficult. The hypertriglyceridemia was initially treated with insulin, antilipidemic medications, and heparin, but the levels of triglycerides remained elevated, delaying results of needed laboratory studies for hours. After plasmapheresis, the serum level of triglycerides decreased by 77% in less than 24 hours. Severe lipemia interferes with photometric laboratory studies, yielding an underestimation of serum levels of electrolytes. Plasmapheresis is safe, rapid, and effective for emergent management of severe hypertriglyceridemia in critically ill patients. The impact of the procedure on critical care nursing is growing as nurses become involved in the treatment and follow-up care of patients who have plasmapheresis. (Critical Care Nurse. 2013;33[4]:18-24) 18 CriticalCareNurse Vol 33, No. 4, AUGUST 2013 www.ccnonline.org by AACN on May 9, 2018 http://ccn.aacnjournals.org/ Downloaded from takes the actual plasmapheresis procedure a step further: Plasma is separated from whole blood and discarded, and then a volume of replacement fluid equal to the volume of the discarded plasma is infused. Usually a patient has a needle or a catheter inserted into a vein in each arm, allowing the blood to be taken from one arm and circulated through the cell separator to remove the plasma. The aspiration device on the machine is adjusted to remove the undesirable blood components and then return the rest...

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Section: Discussionmentioning

confidence: 99%

Plasmapheresis in the Management of Severe Hypertriglyceridemia

Seda

Meyer

Amundson

et al. 2013

Critical Care Nurse

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“…[9] Early plasmapheresis or lipid apheresis can effectively reduce serum triglyceride, inhibit disease progression, and prevent the recurrence of hyperlipidemic pancreatitis, but it has risk of acute coronary events. [10,11] Batashki et al [12] reported that intubation with artifi cial pulmonary ventilation and high volume continuous veno-venous hemofiltration (HV CVVH) should be performed because of the development of polyorgan insuffi ciency and ARDS. In our case, signs and symptoms of ARF were greatly improved after NPPV and conventional therapies, thus creating the opportunity to perform caesarean delivery when fetal distress occurred.…”

Section: Discussionmentioning

confidence: 99%

Acute hyperlipidemic pancreatitis in a pregnant woman

Ying

Chen

et al. 2013

World Journal of Emergency Medicine

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BACKGROUND: Acute pancreatitis is a serious complication during pregnancy, however the incidence of hyperlipidemia induced by pancreatitis is lower. METHODS:We treated a pregnant woman with hypertriglyceridemia-associated acute gestational pancreatitis who simultaneously developed hypoxemic acute respiratory failure (ARF). RESULTS:The woman was successfully treated through noninvasive positive pressure ventilation (NPPV), emergent caesarean delivery, drainage of chylous ascites, and peritoneal lavage. CONCLUSION:The signs and symptoms of ARF were greatly improved in this patient after NPPV and conventional therapies. Early NPPV may be related to good prognosis of the disease.

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“…• Signs and symptoms of hyperlipidemia Hyperlipidemia usually has no noticeable symptoms and tends to be discovered during routine examination or evaluation for atherosclerotic CVD [19]. Commonly found are Xanthoma, Xanthelasma of the eyelid, Chest Pain, Abdominal Pain, Enlarged Spleen, Liver Enlarged, High cholesterol or TG levels, Heart attacks, a Higher rate of obesity and glucose intolerance, Pimple like lesions across the body, Atheromatous plaques in the arteries, Arcussenilis, Xanthomata [20].…”

Section: B) Secondary Hyperlipidemiamentioning

confidence: 99%

Review on Antihyperlipedemia Lipophilic Drugs and Their Novel Formulation Approaches

Khairnar¹,

Shelke²,

Rathod

et al. 2017

Int J Pharm Pharm Sci

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It has been ranked as one of the greatest risk factors contributing to prevalence and severity of coronary heart diseases (CHD). CHD, stroke, atherosclerosis and hyperlipidemia are the primary cause of death. The increased levels of serum total cholesterol and low density lipoprotein (LDL) have been reported as a primary risk factor for cardiovascular disease. Hyperlipidemia is irregularly elevated levels of any or all lipids or lipoproteins in the blood i.e. fatty substances are found in the blood. Many drugs have been reported to inihibit the enzymes responsible for the synthesis of Cholesterol. Wherein, solubility is the key parameter for any active ingredient to maintain the desired therapeutic effects. Since various types of formulations are being currently prepared to enhance its solubility which in turn may improve the bioavailability of the drug? Studies reveal that different methodologies were carried out to overcome the bioavailability issue which is the key limiting factor. The present study focuses on the different types of novel formulation approaches of lipid soluble drug.

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Management of Acute Severe Hyperlipidemic Pancreatitis

Cited by 94 publications

References 52 publications

Plasmapheresis in the Management of Severe Hypertriglyceridemia

Plasmapheresis in the Management of Severe Hypertriglyceridemia

Acute hyperlipidemic pancreatitis in a pregnant woman

Review on Antihyperlipedemia Lipophilic Drugs and Their Novel Formulation Approaches

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