Early goal-directed therapy in severe acute pancreatitis
10.3760/cma.j.issn.1007-8118.2011.06.007
- VernacularTitle:重症急性胰腺炎早期目标治疗研究
- Author:
Yan ZHU
;
Hong CHEN
;
Lei YANG
;
Dachuan LIU
;
Peng YANG
;
Jianguo JIA
;
Jiabang SUN
- Publication Type:Journal Article
- Keywords:
Severe acute pancreatitis;
Fluid therapy;
Early goal-directed therapy;
Marshall score;
APACHE Ⅱ score
- From:
Chinese Journal of Hepatobiliary Surgery
2011;17(6):459-461
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the difference in outcomes between two treatment regimens of goal-directed fluid therapy in patients with severe acute pancreatitis. Methods From January 2000 to January 2010, 80 patients with severe acute pancreatitis were assigned into 2 groups. In group A,patients received fluid therapy aiming at the following goals in 24 hours: (1) Blood pressure >90/60 mm Hg;(2) CVP between 8-12 mm Hg;(3) Urine output >0. 5 ml · kg-1 · h-1. In group B, patients received fluid therapy aiming at the following goals in 6 hours (according to SSC guideline,2004): (1) mean arterial blood pressure >65 mm Hg;(2) CVP between 8-12 mm Hg;(3) Urine output >0. 5 ml · kg-1 · h-1 ;(4) central venous oxygen saturation >70%. After therapy for 3 days we measured the Marshall score, APACHE Ⅱ score, and the peri-pancreatic infection and mortality rates. Results The Marshall score was 6. 82±4. 69 and 4. 48±3. 78 in group A and B, respectively (P=0. 02). The APACHE Ⅱ score was 11. 35±5. 96 and 8. 22±4. 53 in group A and B, respectively (P=0. 01). The peri-pancreatic infection rate was 44% and 37% in group A and B, respectively, and there was no significant difference between the 2 groups (P = 0. 65). The mortality rate was 24% and 17% in group A and B. There was no significant difference between the 2 groups(P=0. 57). Conclusion Goal-directed fluid therapy in patients with severe acute pancreatitis according to the SSC guideline improved organ function but it did not reduce peri-pancreatic infection and mortality rates.
