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Preventive Therapy of Postoperative Intra-abdominal Infection Based on Serum Lactate Changes
A Prospective, Randomized Clinical Trial to Treat Intra-abdominal Infection Preventively After Pancreatic Surgery Based on Serum Lactate Changes
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Postoperative intra-abdominal infection is one of the most serious complications after pancreatic resection. Once diagnosed as postoperative intra-abdominal infection, the patient would not only suffer a lot, but also spend much more money and time in hospital. Moreover, subsequent sepsis and septic shock would imperil the patient's life. The preventive use of antibiotics intraoperatively is the key to prevent this complication, but the time, dosage, and choice of the antibiotics are worth discussing. According to the previous work, the investigators found the changes in serum lactate level on postoperative day (POD) 1 could predict postoperative intra-abdominal infection one week before it really happened. The cutoff level of lactate is 3.25mmol/L. Thus, the investigators recommend preventive use of advanced antibiotics for patients who have a peak serum lactate level of >3.250 mmol/L in 24h after pancreatic resection (doi: 10.1007/s00268-021-05987-8. PMID: 33604712).
The investigators would verify the finding in this randomized controlled trial. Patients with peak lactate level >3.250 mmol/L in POD1 and met other inclusion criteria would be recruited and separated into "preventive use of advanced antibiotics group" (experimental group) and "routine group" (control group) randomly. Patients in experimental group would be treated with advanced antibiotics to avoid postoperative intra-abdominal infection. Patients in control group would be treated with routine method (antibiotics with lower levels). To compare the incidence rate of infection and other complications, as well as the payment and other index, the investigators would see if the patients in experimental group could have better prognosis after pancreatic surgery.
Studietype
Inschrijving (Verwacht)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Yatong Li, MD
- Telefoonnummer: 861069158547
- E-mail: yatongli@qq.com
Studie Locaties
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Beijing
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Beijing, Beijing, China, 100730
- Werving
- Peking Union Medical College Hospital
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Contact:
- Yatong Li, MD
- Telefoonnummer: 861069158547
- E-mail: yatongli@qq.com
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- treatment by pancreatic resection, including pancreaticoduodenectomy, pancreatosplenectomy, total pancreatectomy, and other variant operations;
- revival in the intensive care unit (ICU) with standard serum lactate elution treatments after surgery instead of the operation room or general ward;
- availability of complete preoperative, intraoperative, and postoperative data;
- the peak serum lactate level in 24 hours after surgery >3.250 mmol/L.
Exclusion Criteria:
- a history of surgical treatment of any upper abdominal lesions before the current hospital admission;
- the minimum mean arterial pressure <65 mmHg during the operation;
- without written informed consents for the perioperative situation and related studies.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
---|---|
Experimenteel: Preventive use of advanced antibiotics group
Treat patients in this group with advanced preventive usage of antibiocs: Sulperazon 3g q8h, in postoperative days 1-5.
|
Treat patients in this group with advanced preventive usage of antibiocs: Sulperazon 3g q8h, in postoperative days 1-5.
Andere namen:
|
Ander: Routine group
Treat patients in this group with routine preventive usage of antibiocs: Cefmetazole 1g q12h, in postoperative days 1-3.
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Treat patients in this group with routine preventive usage of antibiocs: Cefmetazole 1g q12h, in postoperative days 1-3.
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Incidence rate of postoperative intra-abdominal infection
Tijdsspanne: in 30 days after surgery
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The incidence rate of postoperative intra-abdominal infection is expected to be lower in experimental group than control group
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in 30 days after surgery
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
The amount of white blood cell
Tijdsspanne: postoperative days 1, 3, 5, 7, 14, 21, 28
|
It is expected to be lower in experimental group than in control group
|
postoperative days 1, 3, 5, 7, 14, 21, 28
|
The level of procalcitonin
Tijdsspanne: postoperative days 1, 3, 5, 7, 14, 21, 28
|
It is expected to be lower in experimental group than in control group
|
postoperative days 1, 3, 5, 7, 14, 21, 28
|
The level of C-reactive protein
Tijdsspanne: postoperative days 1, 3, 5, 7, 14, 21, 28
|
It is expected to be lower in experimental group than in control group
|
postoperative days 1, 3, 5, 7, 14, 21, 28
|
The level of interleukin
Tijdsspanne: postoperative days 1, 3, 5, 7, 14, 21, 28
|
It is expected to be lower in experimental group than in control group
|
postoperative days 1, 3, 5, 7, 14, 21, 28
|
The level of tumor necrosis factor α
Tijdsspanne: postoperative days 1, 3, 5, 7, 14, 21, 28
|
It is expected to be lower in experimental group than in control group
|
postoperative days 1, 3, 5, 7, 14, 21, 28
|
Medewerkers en onderzoekers
Onderzoekers
- Studie directeur: Yatong Li, MD, Peking Union Medical College Hospital
Publicaties en nuttige links
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Studie record data
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Studie start (Werkelijk)
Primaire voltooiing (Verwacht)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- Lac-infection
Plan Individuele Deelnemersgegevens (IPD)
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