Clinical Trial: Neostigmine Treatment of Acute Pancreatitis Combined With Intra-abdominal Hypertension

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: The Curative Effect and Security of Neostigmine Treatment of Acute Pancreatitis Combined With Intra-abdominal Hypertension

Brief Summary: Acute pancreatitis with Intra-abdominal Hypertension have high mortality rate, intra-abdominal pressure mainly because of intestinal paralysis which due to edema, intestinal gas, fluid and other intestinal dysfunction.Neostigmine is an anti-cholinesterase drugs, can enhance intestinal peristalsis, promote flatus, defecation. This study will determine the efficacy of neostigmine in the treatment of acute pancreatitis with Intra-abdominal Hypertension.

Detailed Summary:

The treatment of acute pancreatitis with Intra-abdominal hypertension still no ideal method. At present, through fasting, fluid resuscitation, prevention of shock, to correct acid-base balance and electrolyte imbalance, acid suppression, inhibition of pancreatic secretion, rational use of antibiotics and other general of conservative treatment, such as the failure of conservative treatment may be open decompression surgery, but trauma, and high mortality. Therefore an urgent need to explore and establish effective treatment IAH and Abdominal compartment syndrome to improve SAP's cure rate and reduce mortality.

Neostigmine as an anti-cholinesterase drugs, through acetylcholine in cholinergic transmission and cholinesterase competitively binding site, inhibiting the hydrolysis of acetylcholine, enhance and strengthen the role of cholinergic excitatory parasympathetic activity , restore the patient's bowel movements, so that the body showed a muscarinic (M-like) effect. When gastrointestinal M receptor stimulant can enhance intestinal peristalsis, promote flatus, defecation.

The investigators observed neostigmine can effectively promote intestinal gas, fluid emptying, thereby reducing intra-abdominal pressure. Therefore, prospective studies are needed to clearly worth neostigmine in the treatment of acute pancreatitis with IAH efficacy and safety.


Sponsor: The First Affiliated Hospital of Nanchang University

Current Primary Outcome: The change of intra-abdominal pressure From admission to seventh days [ Time Frame: From admission to seventh days,Measured once every 6 hours ]

Drug use for 7 days,Through the Bladder pressure measurement reaction intra-abdominal pressure


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Intestinal motility and intestinal emptying function [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • Incidence and duration of abdominal compartment syndrome [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • Incidence and duration of organ failure [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • Mortality [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • Adverse events during treatment [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • the recurrence rate of Intra-abdominal hypertension [ Time Frame: From admission to seventh days ]
    Drug use for 7 days
  • The Security of Neostigmine [ Time Frame: From admission to seventh days ]
    Drug use for 7 days


Original Secondary Outcome: Same as current

Information By: The First Affiliated Hospital of Nanchang University

Dates:
Date Received: August 27, 2015
Date Started: September 2015
Date Completion: December 2017
Last Updated: September 4, 2015
Last Verified: September 2015