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array:22 [ "pii" => "S0025775300716745" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71674-5" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71674" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:721-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3889 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3599 "PDF" => 284 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300716757" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71675-7" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71675" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:726-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 8039 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 7707 "PDF" => 326 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Dieta y riesgo cardiovascular en España (DRECE II). Descripción de la evolución del perfil cardiovascular" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "726" "paginaFinal" => "729" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diet and cardiovascular risk in Spain (DRECE II study). Description of the evolution of cardiovascular profile" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Antonio Gutiérrez Fuentes, Juan Gómez-Jerique, Agustín Gómez de la Cámarac, Miguel Ángel Rubio, Alberto García Hernández, Ignacio Arístegui" "autores" => array:7 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Antonio Gutiérrez Fuentes" ] 1 => array:2 [ "nombre" => "Juan" "apellidos" => "Gómez-Jerique" ] 2 => array:2 [ "nombre" => "Agustín" "apellidos" => "Gómez de la Cámarac" ] 3 => array:2 [ "nombre" => "Miguel" "apellidos" => "Ángel Rubio" ] 4 => array:2 [ "nombre" => "Alberto" "apellidos" => "García Hernández" ] 5 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Arístegui" ] 6 => array:1 [ "colaborador" => "en nombre del grupo Drece II" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300716757?idApp=UINPBA00004N" "url" => "/00257753/0000011500000019/v1_201307291749/S0025775300716757/v1_201307291749/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Características y valor pronóstico del fracaso renal agudo en la pancreatitis aguda grave" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "721" "paginaFinal" => "725" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Manuel E. Herrera Gutiérrez, Gemma Seller Pérez, Carlos de la Rubia de Gracia, María José Chaparro Sánchez, Belén Nacle López" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Manuel E." "apellidos" => "Herrera Gutiérrez" "email" => array:1 [ 0 => "herrera@ctv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Gemma" "apellidos" => "Seller Pérez" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "de la Rubia de Gracia" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "José Chaparro Sánchez" ] 4 => array:2 [ "nombre" => "Belén" "apellidos" => "Nacle López" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cuidados Críticos y Urgencias. Complejo Hospitalario Carlos Haya. Málaga" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. M.E. Herrera Gutiérrez. UCI. Complejo Hospitalario Carlos Haya. Avda. Carlos Haya, s/n. 29010 Málaga" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Acute renal failure profile and prognostic value in severe acute pancreatitis." ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-01-20" "fechaAceptado" => "2000-11-09" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec223127" "palabras" => array:3 [ 0 => "Pancreatitis aguda grave" 1 => "Fracaso renal agudo" 2 => "Hemofiltración venovenosa continua" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec223126" "palabras" => array:3 [ 0 => "Severe acute pancreatitis" 1 => "Acute renal failure" 2 => "Hemofiltration" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La aparición de fracaso renal agudo (FRA) en la pancreatitis aguda grave (PAG) supone una elevada mortalidad. No existen parámetros que definan los pacientes con mayor probabilidad de desarrollarlo. Pretendemos determinar la incidencia y definir variables predic-toras de aparición y mortalidad</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de todas las PAG ingresadas en la unidad de cuidados intensivos entre 1991 y 1998 (n = 154)</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La incidencia de FRA fue del 42% (60% durante el primer día). La alteración de los parámetros hemodinámicos, el índice APACHE II y la puntuación de Ranson se relacionaron con su aparición. El 62,2% de los casos graves aparecen tras un fracaso multiorgánico (FMO). La mortalidad fue del 71,2% frente al 6,8% en pacientes sin FRA (en episodios de gravedad media del 39,9%, y en graves del 94,6%). La etiología condicionó la mortalidad (prerrenal [46,4%], tras hipotensión mantenida [71,4%] y FMO [93,3%]; p < 0,005). Precisaron reemplazo renal el 63,6% de los pacientes (hemofiltración [HF] el 95,5%), con una mortalidad del 89,3% (100% en hemodiálisis intermitente [HI] frente al 88% con HF). En el 32% de los pacientes con HF mejoró o se resolvió el FRA (si se inició precozmente la mortalidad fue del 76,9% frente al 100% en los tratamientos tardíos) (p < 0,001). El análisis de regresión presenta una relación significativa con la mortalidad para la gravedad del episodio de FRA y fracaso hemodinámico al ingreso</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El fracaso renal agudo en la pancreatitis aguda grave es frecuente, aparece pre-cozmente y ensombrece su pronóstico. La necesidad de tratamiento de depuración supone una mortalidad muy elevada. La hemofiltración parece presentar ventajas sobre la hemodiálisis intermitente</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Acute renal failure (ARF) complicating severe acute pancreatitis (SAP) carries a high mortality. Clinically useful scores to define patients who will develop this complication are lacking. We try to determine the incidence of ARF and variables predicting the appearance and severity of the episodes</p> <span class="elsevierStyleSectionTitle">Material and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of all SAP patients admitted in an intensive care unit between 1991 and 1998 (n = 154)</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">ARF incidence was 42%. Haemodynamic instability, APACHE II and Ranson score were related to ARF development. 62.2% of severe ARF patients had multiple organ failure (MOF). Mortality was 71.2% compared to 6.8% in patients without ARF (39.9% in mild ARF and 94.6% in severe ARF). Etiology relates to mortality (prerenal [46.4%], after severe hypo-tensive episode [71.4%], in MOF [93.3%]; p < 0.005). 63.6% patients required replacement therapy (hemofiltration [HF] 95.5%), with a mortality of 89.3% (100% for intermittent dialysis compared to 88% with HF). In 32% patients treated with HF, ARF improved (when initiated early mortality was 76.9% compared to a 100% when initiated in more advanced stages) (p < 0.001). Logistic regression analysis showed that ARF severity and haemodynamic failure were related with mortality</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ARF is a frequent and early complication of SAP, worsening its prognosis. FRA severity is related to the outcome. Need of replacement therapy supposes a high mortality. In this setting, HF seems to have advantages over conventional dialysis</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias BibliogrÁficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:56 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pancreatite aigue hemorragique." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Varlet" 1 => "J.L. Pourriat" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Press Med" "fecha" => "1996" "volumen" => "25" "paginaInicial" => "1453" "paginaFinal" => "1458" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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