RESUMO
Increased of proinflammatory cytokines levels, including interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) on severe acute pancreatitis causes vasodilatation, increased permeability of the wall, accumulation of fluid in lung tissue and pleural sinuses. Transudate from acute parapancreatyc clusters of hot liquid and abdomen falls into the chest cavity through microscopic defects in the diaphragm due to the formation of pathological pleural-peritoneal connections or the relevant pressure gradient between the abdominal and pleural cavities. Remediation and removal of acute parapancreatyc clusters combined with the use of a multicomponent drug infusion therapy Cytoflavin provide a reduction in the frequency of pulmonary complications of acute pancreatitis from 48.3 to 31.0%. Use of the drug Cytoflavin reduces the severity of endogenous intoxication and mortality from acute lung injury from 12.9 to 6.1%.
Assuntos
Lesão Pulmonar Aguda/tratamento farmacológico , Mononucleotídeo de Flavina/uso terapêutico , Hidratação/métodos , Inosina Difosfato/uso terapêutico , Pulmão/efeitos dos fármacos , Niacinamida/uso terapêutico , Pancreatite/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Succinatos/uso terapêutico , Doença Aguda , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/patologia , Adulto , Idoso , Antioxidantes/metabolismo , Permeabilidade Capilar/efeitos dos fármacos , Diafragma/efeitos dos fármacos , Diafragma/metabolismo , Diafragma/patologia , Combinação de Medicamentos , Exsudatos e Transudatos/efeitos dos fármacos , Feminino , Humanos , Interleucina-8/antagonistas & inibidores , Interleucina-8/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Pâncreas/efeitos dos fármacos , Pâncreas/metabolismo , Pâncreas/patologia , Pancreatite/etiologia , Pancreatite/metabolismo , Pancreatite/patologia , Peritônio/efeitos dos fármacos , Peritônio/metabolismo , Peritônio/patologia , Pleura/efeitos dos fármacos , Pleura/metabolismo , Pleura/patologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/metabolismo , Vasodilatação/efeitos dos fármacosRESUMO
The results of examination of 68 patients, admitted to hospital for an acute pancreatitis during 48 h from its occurrence, were analyzed. In all the patients the cytokines (IL-8, IL-10, TNF-alpha) content was determined in the blood, using immunoenzymal analysis. Algorithm of prognostication of an acute pancreatitis-associated pulmonary injury, basing on determination of the cytokines contents, was elaborated.
