Efficacy of continuous regional arterial infusion of a protease inhibitor and antibiotic for severe acute pancreatitis in patients admitted to an intensive care unit.
To investigate the efficacy of continuous regional arterial infusion (CRAI) of a protease inhibitor and antibiotic for severe acute pancreatitis (SAP) in patients admitted to an intensive care unit (ICU). A total of 51 patients with SAP requiring admission to an ICU were studied. The patients were divided into two groups: one received the protease inhibitor nafamostat mesylate and the antibiotic imipenem by continuous regional arterial infusion (CRAI group) and the other received protease inhibitors and antibiotics by intravenous infusion (non-CRAI group). To evaluate the therapeutic usefulness of CRAI of a protease inhibitor and antibiotic for SAP, the rate of surgery and the cumulative survival rate were compared between the non-CRAI group and the CRAI group. The rate of surgery was 32% in the non-CRAI group and 9% in the CRAI group (P = 0.08). Cumulative survival rates at 1, 6, and 12 months were 77.9%, 48.9%, and 48.9% in the non-CRAI group compared with 100.0%, 100.0%, and 87.1% in the CRAI group. Outcome was thus significantly better in the CRAI group than in the non-CRAI group (P = 0.002). CRAI of a protease inhibitor and antibiotic may decrease the need for surgical therapy and reduce mortality in patients with SAP.
Imaizumi
Hiroshi
H
Department of Gastroenterology, Emergency and Critical Care Medicine, Kitasato University Hospital, Kanagawa, Japan. imaizumi@yhc.att.ne.jp
Kida
Mitsuhiro
M
Nishimaki
Hiroshi
H
Okuno
Junko
J
Kataoka
Yuichi
Y
Kida
Yoshiki
Y
Soma
Kazui
K
Saigenji
Katsunori
K
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001550:Benzamidines; D004359:Drug Therapy, Combination; D005260:Female; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D007261:Infusions, Intra-Arterial; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; D015378:Imipenem; C032855:nafamostat