title: Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis.
abstract: OBJECTIVE
  To evaluate the efficacy of continuous regional arterial infusion therapy (CRAI) with gabexate mesilate and antibiotics for severe acute pancreatitis (SAP).
  
  
  METHODS
  We conducted a prospective study on patients who developed SAP with or without CRAI. Out of 18 patients fulfilled clinical diagnostic criteria for SAP in Japan, 9 patients underwent CRAI, while 9 patients underwent conventional systemic protease inhibitor and antibiotics therapy (non-CRAI). CRAI was initiated within 72 h of the onset of pancreatitis. Gabexate mesilate (2400 mg/d) was continuously administered for 3 to 5 d. The clinical outcome including serum inflammation-related parameters were examined.
  
  
  RESULTS
  The duration of abdominal pain in the CRAI group was 1.9+/-0.26 d, whereas that in the non-CRAI group was 4.3+/-0.50. The duration of SIRS in the CRAI group was 2.2+/-0.22 d, whereas that in the non-CRAI group was 3.2+/-0.28. Abdominal pain and SIRS disappeared significantly in a short period of time after the initiation of CRAI using gabexate mesilate. The average length of hospitalization significantly differed between the CRAI and non-CRAI groups, 53.3+/-7.9 d and 87.4+/-13.9 d, respectively. During the first two weeks, levels of serum CRP and the IL6/IL10 ratio in the CRAI group tended to have a rapid decrease compared to those in the non-CRAI group.
  
  
  CONCLUSIONS
  The present results suggest that CRAI using gabexate mesilate was effective against SAP.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, and Department of Gastroenterology, Saiseikai Fukuoka General Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ino
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Arita
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Akashi
authors.forename: Toshinari
authors.initials: T
authors.lastname: Kimura
authors.forename: Hisato
authors.initials: H
authors.lastname: Igarashi
authors.forename: Takamasa
authors.initials: T
authors.lastname: Oono
authors.forename: Masayuki
authors.initials: M
authors.lastname: Furukawa
authors.forename: Ken
authors.initials: K
authors.lastname: Kawabe
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ogoshi
authors.forename: Jiro
authors.initials: J
authors.lastname: Ouchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Miyahara
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
authors.forename: Tetsuhide
authors.initials: T
authors.lastname: Ito
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D016670:Gabexate / Q000008:administration & dosage*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007261:Infusions, Intra-Arterial; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D011446:Prospective Studies; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage*; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D015842:Serine Proteinase Inhibitors; D016753:Interleukin-10; D016670:Gabexate; D002097:C-Reactive Protein