Acute triglyceride (TG) lowering therapy is crucial in the early treatment of hypertriglyceridemia (HTG)-induced pancreatitis. Data concerning continuous intravenous infusion of insulin and heparin therapy (IHT) as an equivalent option to plasma exchange (PE) in HTG-induced pancreatitis are limited” Jin et al (2018).
Abstract:
BACKGROUND: Acute triglyceride (TG) lowering therapy is crucial in the early treatment of hypertriglyceridemia (HTG)-induced pancreatitis. Data concerning continuous intravenous infusion of insulin and heparin therapy (IHT) as an equivalent option to plasma exchange (PE) in HTG-induced pancreatitis are limited. We performed this study to compare the IHT and PE abilities to lower TG levels in the acute phase of HTG-induced pancreatitis.
METHODS: This was a retrospective observational study conducted in a tertiary teaching hospital. Patients with HTG-induced pancreatitis were consecutively enrolled from Oct 2013 to Oct 2017. The primary outcome was the reduction in the TG level.
RESULTS: Sixty-four patients were valid for assessment, 34 (53.1%) patients were included in the IHT group. A reduced TG level by 74.7±13.8% was observed after the first PE session, and a reduced TG level by 75.0±14.6% was observed after the 1st day of IHT. There were no significant differences in the reduction of TG (F=0.015, P>0.05), high-sensitivity C reactive protein (F=0.698, P>0.05) and the Acute Physiology and Chronic Health Evaluation II score (F=0.954, P>0.05) between the IHT group and the PE group. The cost of medical care in hospital was significant lower in the IHT group than the PE group (59512.4±23645.1 RMB vs 105483.9±58815.4 RMB, P<0.05). No adverse effect was observed in the IHT group. CONCLUSIONS: As a minimally invasive and economical strategy, IHT is effective and equivalent to PE in achieving a fast reduction in TG levels.
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Reference:
Jin, M., Peng, J., Zhang, H., Lu, B., Lii, Y., Wu, D., Qian, J. and Yang, H. (2018) Continuous intravenous infusion of insulin and heparin versus plasma exchange in hypertriglyceridemia-induced acute pancreatitis. Journal of Digestive Diseases. August 17th. [epub ahead of print].
doi: 10.1111/1751-2980.12659.