Original Article
A strategy of fluid resuscitation in severe acute pancreatitis guided by oxygenation index combined with abdominal pressure
Xu Mingyue, He Lei, Liu Zhiwei, Xin Xianlei, Ma Huanxian, Su Maosheng, Wang He, Liang Jinghua, Zhao Yongsheng, Cai Shouwang
Published 2016-09-28
Cite as Chin J Hepatobiliary Surg, 2016,22(09): 618-622. DOI: 10.3760/cma.j.issn.1007-8118.2016.09.011
Abstract
ObjectiveTo study the strategy of fluid resuscitation in severe acute pancreatitis (SAP) guided by oxygenation index combined with abdominal pressure.
MethodsFrom January 2012 to January 2014, 40 patients with SAP were included in the study. All the patients received a treatment protocol designed by the physician group in ICU using oxygenation index and abdominal pressure to guide treatment. These patients were divided into the positive fluid equilibrium and the negative fluid equilibrium groups according to the status of fluid equilibrium after 72 h of treatment.
ResultsAmong the 40 patients, 24 patients showed a positive fluid equilibrium after 72 h of fluid treatment. The average amount of fluid equilibrium was (5 191.8±1 596.5) ml, and the oxygenation index was significantly higher than that before treatment (296.5±60.0 vs 220.3±59.0, P<0.01). The abdominal pressure was also higher than that before treatment (11.0±2.2 vs 10.6±2.2, P>0.05), though there was no significant difference. 16 patients showed a negative fluid equilibrium. The average amount of fluid equilibrium was (-3 762.2±3 550.6) ml, and the oxygenation index was significantly higher than that before treatment (309.4±42.7 vs 198.5±47.6, P<0.01). The abdominal pressure was significantly lower than that before treatment (11.2±1.6 vs 14.5±2.2, P<0.01). In 72.9% of patients the fluid resuscitation goals were achieved. These included 19 patients in the positive fluid equilibrium group and 14 patients in the negative fluid equilibrium group. There was no significant differences between the two groups (χ2=0.462, P>0.05).
ConclusionsUsing oxygenation index and abdominal pressure to guide treatment could result in effective fluid resuscitation in SAP. This treatment strategy effectively improved prognosis of patients with SAP.
Key words:
Severe acute pancreatitis; Fluid resuscitation; Oxygen index; Intra-abdominal hypertension
Contributor Information
Xu Mingyue
Intensive Care Unit, Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
He Lei
Liu Zhiwei
Xin Xianlei
Ma Huanxian
Su Maosheng
Wang He
Liang Jinghua
Zhao Yongsheng
Cai Shouwang
