Uvarov V. Prophylactic and treatment of acute pancreatitis complications

In the first group for detoxification was used forced diuresis with fluid resuscitation. In the second group in 12-24 hours after admission we use plasmafferesis on Haemonetics PCS-2 ("Haemonetics", USA) device, 800-1000 ml of plasma was exfused, from 2 to 6 sessions from the second day were done. Algorithm of prophylactic and treatment of severe acute pancreatitis was developed. The basis of the algorithm was to determine the patients with high complications risk on the account of clinical, laboratory and instrumental criteria and use of complex treatment and plasmafferesis for prophylaxis and treatment of complications. Use of proposed treatment leads to decrease of complications rate: pneumonia and pleuritis from 42.3% in the first group to 25.5% in the second group, intoxication psychosis from 24.0 to 11.8%, liver insufficiency from 43.3 to 23.5%, fermentative peritonitis from 12.5 to 3.5%, persistant MOF from 16.4 to 10.8%, renal insufficiency from 6.7 to 3.9%, acute gastrointestinal ulcers from 6.7 to 3.9%, pancreatic shock from 11.5 to 6.9% and infected pancreatic necrosis from 34.6 to 26.5%. Effectiveness of developed program proved by decrease of operated patients number on 8.1% and mortality from 15.4 to 8.8%.