Continuous insulin therapy versus apheresis in patients with hypertriglyceridemia-associated pancreatitis.

Autor:	Araz F; Adana Dr. Turgut Noyan Training and Research Hospital, Gastroenterology, Baskent University, Adana.; Medical Faculty, Gastroenterology, Baskent University, Ankara., Bakiner OS; Adana Dr. Turgut Noyan Training and Research Hospital, Endocrinology, Baskent University, Adana., Bagir GS; Adana Dr. Turgut Noyan Training and Research Hospital, Endocrinology, Baskent University, Adana., Soydas B; Adana Dr. Turgut Noyan Training and Research Hospital, Gastroenterology, Baskent University, Adana.; Medical Faculty, Gastroenterology, Baskent University, Ankara., Ozer B; Adana Dr. Turgut Noyan Training and Research Hospital, Gastroenterology, Baskent University, Adana.; Medical Faculty, Gastroenterology, Baskent University, Ankara., Kozanoglu I; Medical Faculty, Physiology Department, Baskent University, Ankara.; Adana Dr. Turgut Noyan Training and Research Hospital, Adult Bone Marrow Transplantation Center, Apheresis Unit, Baskent University, Adana, Turkey.
Jazyk:	angličtina
Zdroj:	European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2022 Feb 01; Vol. 34 (2), pp. 146-152.
DOI:	10.1097/MEG.0000000000002025
Abstrakt:	Background: The optimal treatment modality for lowering the triglyceride level in patients with hypertriglyceridemia (HTG)-associated acute pancreatitis is unknown. We evaluated the efficacy of continuous insulin infusion and apheresis procedures as triglyceride-lowering therapy. Materials and Methods: Clinical, demographic, and laboratory data were retrospectively evaluated for patients with HTG-associated pancreatitis who received continuous insulin infusion or apheresis in a single tertiary center. The endpoints were modality effectiveness and clinical outcomes. Results: The study included 48 patients (mean age, 40.4 ± 9.9 years). Apheresis and insulin infusion were performed in 19 and 29 patients, respectively, in the first 24 h of hospital admission. Apheresis procedures included therapeutic plasma exchange in 10 patients and double filtration plasmapheresis in nine patients. Baseline mean triglyceride level was higher in the apheresis group. The two groups were similar in terms of other baseline clinical and demographic characteristics. Seventeen patients (58.6%) in the insulin group and nine patients (47.4%) in the apheresis group exhibited Balthazar grades D-E. There was a rapid reduction (78.5%) in triglyceride level after the first session of apheresis. Insulin infusion resulted in a 44.4% reduction in mean triglyceride level in the first 24 h. The durations of fasting and hospital stay, and the rates of respiratory failure and hypotension, were similar between groups. More patients in the apheresis group experienced acute renal failure or altered mental status. Prognosis did not significantly differ between groups. Conclusion: Although apheresis treatments are safe and effective, they provided no clear benefit over insulin infusion for HTG-associated pancreatitis. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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