REDUCING THE LETHALITY IN ACUTE-PANCREATI TIS WITH SODIUM SELENITE - CLINICAL-RESULTS OF 4-YEAR ANTIOXIDANT THERAPY

Results obtained from pancreatitis research prove the genesis if free radicals in acute pancreatitis. Xenobiotics, ethanol as well as biliar y diseases will induce a defeciency in antioxidants. In antioxidative treatment sodium selenite as a water soluble redox substance represent ed an alternative. In the middle of the year 1990 the therapy regime w as introduced in Rostock, a short time later in Dresden too. The diagn osis was made by CT enhanced by a contrast medium as well as by clinic al and paraclinical parameters. CT was repeated after a week. Up to Ma y 31, 1994 there were 245 patients treated in Rostock and 85 patients in Dresden (n = 330). Immediately after making the diagnosis 200 mug w ere given as a bolus, 800 mug in the following 24 hours. From the seco nd day on 500 mug of selenite were administered daily. In addition, in fusions of carbohydrates, electrolytes (no calcium), fluid and analget ics were given. Lavation of the intestine was made three times daily. With a well-timed selenium therapy the rates of letality, complication s and operation dropped drastically. In spite of a constant number of patients no patient has died in Rostock since 1993, in Dresden 8 of 85 patients came ad exitum. Complications occured if the therapy began t oo late (if patients were administered too late) and in biliary forms. Conclusion: An improvement in the prognosis of acute pancreatitis can be achieved if antioxidative selenium therapy with sodium selenite is introduced in time. In rare cases total necroses and complications in organs only occured in those patients who were admitted to this thera py too late.