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Effect of liquid resuscitation on homeostasis of patients with severe acute pancreatitis

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Author:
No author available
Journal Title:
CHINESE CRITICAL CARE MEDICINE
Issue:
9
DOI:
10.3760/cma.j.issn.1003-0603.2010.09.004
Key Word:
液体复苏;胰腺炎,急性,重症;内稳态;Liquid resuscitation;Severe acute pancreatitis;Homeostasis

Abstract: Objective To evaluate the effect of liquid resuscitation on acid-base balance and electrolytes of patients with severe acute pancreatitis (SAP). Methods According to the target of liquid resuscitation, 22 patients with SAP involved in this self-controlled prospective study received sufficient liquid resuscitation in acute stage of acute pancreatitis. The results of blood gas analysis, acid-base balance and electrolytes were compared before and after liquid resuscitation. The correlation between the volume of liquid used in resuscitation and the level of blood chlorine was analyzed. Results The mean resuscitation duration was (15.0±2.4) hours, and the volume of liquid resuscitation was 3 459 4 203 ml, with mean volume (3 910±102) ml in 22 patients; blood sodium (mmol/L) and chlorine (mmol/L) levels were both significantly higher after resuscitation compared with those before resuscitation (Na+: 145.83±1.85 vs. 139.67±2.25, Cl-: 117.33±1.64 vs. 101.83±1.77, both P<0.05). Blood pH value, hematocrit (Hct), anion gap (AG, mmol/L), blood lactic acid (mmol/L) were slightly lowered after resuscitation (pH value: 7.39±0.02 vs. 7.42±0.02, Hct: 35.63±1.58 vs. 46.85±2.38, AG: 8.02±1.21 vs. 14.47±0.89, blood lactic acid: 1.10±0.18 vs. 1.97±0.15, P<0.05 or P<0.01). In addition, the level of blood chlorine was significantly correlated with the volume of liquid used in resuscitation (r=0.720 8, P<0.01). Conclusion The target of liquid resuscitation in patients with SAP should be cautiously determined, including control of the volume of liquid for resuscitation, in order to avoid acid-base imbalance or hyperchloraemia. At the same time, the change in internal environment should be monitored.

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