[Systemic disorders management in patients with acute pancreatic necrosis]

To study the effectiveness of sulodexide for systemic disorders correction in patients with acute pancreatic necrosis.

The study included 60 patients with acute pancreatic necrosis who were divided into main and control groups by 30  patients. Their age varied from 27 to 79. Standard combined therapy with prevention of disseminated intravascular coagulation and thrombotic complications was recommended in all patients. In the control group enoxaparin therapy in prophylactic doses (4,000 IU (40 mg) per day) was used. Mean duration of treatment was 6±0.9 days. Sulodexide was used in the main group. Sulodexide was administered since the 1st hospital day 600 LE per day intravenously for 5-10 days. The duration of treatment was determined according to clinical course and «capillary leak» that was measured by serum proteins loss. Mean duration was 8.8±0.3 days.

Hospital-stay was significantly lower in study group than in control group for about 5±2.2 days (p<0.03). Overall mortality was lower by 10%. In both groups unfavorable outcomes were caused by severe multiple organ failure. There were no deaths in case of SOFA score less than 6. In the main group mortality of patients with severe multiple organ failure was 2.4 times lower than in the control group (14% vs. 33%).

Correction of microcirculation and tissue perfusion improves the severity of systemic manifestations of acute destructive pancreatitis. Mortality and hospital-stay were decreased due to reduced incidence, severity and duration of multiple organ failure and frequency of complications.