Document Detail


Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study.
MedLine Citation:
PMID:  17523328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Experimental and clinical studies demonstrated that probiotics containing lactobacilli significantly improve the outcome of acute pancreatitis. In a prospective, randomized, double-blinded study the role of "Synbiotic 2000", a new synbiotic composition with high colony forming unit (CFU) was evaluated in the treatment of severe acute pancreatitis. METHODOLOGY: Patients with severe acute pancreatitis were randomized into two groups. Nasojejunal feeding was commenced within 24 hours after admission in both groups and continued for at least seven days. The first group of patients received four different lactobacilli preparations with 1010 CFU, respectively, and prebiotics containing four bioactive fibers (inulin, beta-glucan, resistant starch and pectin) in addition. Patients in the second (control) group received only prebiotics. RESULTS: 62 patients with severe acute pancreatitis completed the study. Altogether 8 patients died. Lower incidence of multiorgan failure (MOF), septic complications and mortality were detected in the first group compared to the control, but the differences were not significant statistically. The total incidence of systemic inflammatory response syndrome (SIRS) and MOF were significantly different between the two groups (8 vs. 14; p < 0.05). Furthermore, the number patients recovering with complications were significantly less in the first group receiving modern synbiotic therapy compared to the control (p < 0.05). Finally, lower rate of late (over 48 hours) organ failure was detected in the first versus the control group (3.0% vs. 17.2%). CONCLUSIONS: The results suggest that early nasojejunal feeding with synbiotics may prevent organ dysfunctions in the late phase of severe acute pancreatitis. In addition, the data also indicate that the infection of pancreatic necrosis may be associated with early phase organ failure.
Authors:
Attila Oláh; Tibor Belágyi; László Pótó; László Romics; Stig Bengmark
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  54     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-05-25     Completed Date:  2007-08-01     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  590-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Petz Aladár Teaching Hospital, Györ, Hungary. olaha@petz.gyor.hu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacterial Infections / mortality,  therapy*
Cilastatin / administration & dosage
Combined Modality Therapy
Dietary Fiber / administration & dosage*
Dietary Supplements*
Double-Blind Method
Drug Combinations
Enteral Nutrition*
Female
Humans
Imipenem / administration & dosage
Male
Middle Aged
Multiple Organ Failure / etiology,  mortality,  prevention & control
Pancreatitis, Acute Necrotizing / mortality,  therapy*
Probiotics / administration & dosage*
Prospective Studies
Survival Rate
Systemic Inflammatory Response Syndrome / mortality,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Drug Combinations; 74431-23-5/Imipenem; 82009-34-5/Cilastatin; 92309-29-0/cilastatin, imipenem drug combination
Comments/Corrections
Comment In:
Curr Gastroenterol Rep. 2009 Aug;11(4):257-8   [PMID:  19615299 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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