Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis

Siriwardena, Ajith K.; Mason, James; Balachandra, Srinivasan; Bagul, Anil; Galloway, Simon; Formela, Laura; Hardman, Jonathan G.; Jamdar, Saurabh

doi:10.1136/gut.2006.115873

Cited by 156 publications

(95 citation statements)

References 20 publications

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“…31 The systematic review and meta-analysis undertaken by our group 31 substantially builds on the initial very important review by Heyland et al 9 by including seven new trials, including the first four multi-centre randomised controlled trials in this area of research. [32][33][34][35] This updated review 31 indicates and supports previous findings 9 that micronutrient supplementation in the critically ill may be associated with a reduction in overall mortality, and specifically 28 day mortality.…”

Section: Synthesis Of the Evidencesupporting

confidence: 57%

“…35 This study by Siriwardena et al, 35 conducted in patients with severe acute pancreatitis, indicated a trend towards worse outcome in the treatment arm of the study (although results were not statistically significant and not demonstrably treatment related). The outcome of this study warrants caution, at least in patients with severe acute pancreatitis.…”

Section: Synthesis Of the Evidencementioning

confidence: 99%

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Micronutrients: do small things matter?

Visser

2010

South African Journal of Clinical Nutrition

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Section: Synthesis Of the Evidencesupporting

confidence: 57%

Section: Synthesis Of the Evidencementioning

confidence: 99%

Micronutrients: do small things matter?

Visser

2010

South African Journal of Clinical Nutrition

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“…Recently, Siriwardena et al (36) reported a nicely designed randomized, double-blinded, placebo-controlled trial on intravenous antioxidant treatment for SAP. The study was performed on patients with predicted SAP, managed according to the United Kingdom guidelines for the management of AP (26), and the authors found that antioxidant supplementation was not useful to avoid MOF, ameliorate patient outcomes or reduce length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Malondialdehyde in early phase of acute pancreatitis

Hernández

Miranda

Pascual

et al. 2011

Rev. esp. enferm. dig.

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Aims: to assess oxidative stress in acute pancreatitis, its evolution over time and its relationship with the severity of the disease.Methods: during a two-year period, patients with acute pancreatitis with less than 24 hours of pain were evaluated. Serum was obtained the first, second and fourth day from admittance, if complications were detected, and after recovery. Malondialdehyde was determined by high performance liquid chromatography. Twenty healthy volunteers constituted the control group. Malondialdehyde between groups was compared with Mann-Whitney and KruskalWallis tests; malondialdehyde evolution was studied with Wilcoxon test.Results: one hundred and sixty-nine patients were included (91 women, median age 67 years, range 20-95); 33 suffered a severe episode. Malondialdehyde decreased from first to fourth day (0.600 vs. 0.451 vs. 0.343 M, respectively, p < 0.05). When complications were detected, malondialdehyde level was similar to that of first and second day (0.473 M, p > 0.05). In severe attacks malondialdehyde was higher than in control group at day 2 (severe: 0.514; mild: 0.440; control: 0.347 M, p < 0.05 severe vs. control).Conclusions: an early oxidative stress is observed in acute pancreatitis. In severe attacks, oxidative stress remains high longer than in mild episodes. The onset of complications is associated with high malondialdehyde concentration.

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“…The first study was performed on 84 patients and showed increased recovery rate, improved cellular immune function as well as reduced rate of complications and LOS in the intervention group [44]. In the second study of 43 patients, vitamin C, selenium, and n-acetylcystein treatment did not improve organ function, mortality, and LOS and did not reduce oxidative stress [45]. Three other RCTs investigated the effect of n-3 fatty acids supplementation in oncology patients.…”

Section: Micronutrients and Other Nutrients Requirementsmentioning

confidence: 99%

Detection and treatment of medical inpatients with or at-risk of malnutrition: Suggested procedures based on validated guidelines

et al. 2016

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a lack of knowledge in regard to detecting disease-related malnutrition and implementing nutritional support. Our aim was to suggest practical procedures for screening and treating malnourished or at-risk patients hospitalized in medical wards, thereby fostering a straightforward implementation of nutritional therapy independent of the underlying disease and comorbidities. Methods: A working group of experts in clinical nutrition selected and analyzed published diseasespecific European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines relevant for our aim. Eight questions in population, intervention, control, outcome format were defined to cover topics such as screening, nutritional targets, and routes of feeding. Individual studies were extracted from the guidelines by applying inclusion and exclusion criteria targeting the heterogeneous population of medical inpatients with or at-risk of disease-related malnutrition. We used those studies as evidence, as well as recommendations from the selected ESPEN guidelines, to formulate answers to the questions

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Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis

Cited by 156 publications

References 20 publications

Micronutrients: do small things matter?

Micronutrients: do small things matter?

Malondialdehyde in early phase of acute pancreatitis

Detection and treatment of medical inpatients with or at-risk of malnutrition: Suggested procedures based on validated guidelines

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