The effect of initial fluid resuscitation with different ratio of crystalloid-colloid on prognosis of patients with severe acute pancreatitis

Abstract

Objective To investigate the effect of initial fluid resuscitation with different liquid crystal glue ratio on prognosis of patients with severe acute pancreatitis(SAP).Methods Ninety-four cases of SAP patients were selected,with the first 24 h liquid crystal glue ratio of 1.5 and 3.0 for the sector,were divided into low crystal glue ratio group(crystal glue ratio ＜ 1.5,26 cases),microtek glue ratio group (crystal glue ratio 1.5-3.0,30 cases)and high crystal glue ratio group(crystal glue ratio ＞3.0,38cases).24 h mechanical ventilation rate,oxygenation index,intra-abdominal pressure(IAP),third interstitial fluid retention,the parameters of fluid resuscitation and 2 week survival rate were observed in three groups.Results 24 h crystal solution volume,crystal glue ratio,third interstitial fluid retention and 72 h infusion volume in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [(3612 ± 799)ml vs.(2309 ±417),(2125 ±478)ml,(3.66 ± 0.14)vs.(2.44 ±0.15),(1.42 ±0.09),(2835 ±632)ml vs.(1889 ±283),(1866 ±305)ml,(11942 ± 1162)ml vs.(9037 ± 983),(9401 ± 1052)ml],and there were significant differences(P ＜ 0.05).24 h crystal glue ratio in microtek glue ratio group was higher than that in low crystal glue ratio group,and there was significant difference(P＜ 0.05).24 h glue volume in low crystal glue ratio group was higher than that in high crystal glue ratio group and microtek glue ratio group [(1507 ± 335)ml vs.(994 ± 234),(949 ± 141)ml],and there were significant differences(P＜0.05).There was no significant difference in 24 h crystal volume,third interstitial fluid retention and 72 h infusion volume between microtek glue ratio group and low crystal glue ratio group(P＞ 0.05).24 h mechanical ventilation rate,IAP in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [65.8％(25/38)vs.23.3％(7/30),26.9％(7/26),(16.9 ± 3.7)cm H2O(1 cm H2O =0.098 kPa)vs.(13.5 ± 3.6),(13.2 ± 3.4)cm H2O],24 h oxygenation index was lower than that in microtek glue ratio group and low crystal glue ratio group [(180.8 ±26.4)mm Hg(1 mm Hg =0.133 kPa)vs.(280.7 ±24.9),(260.4 ±25.8)mm Hg],and there was significant difference(P ＜ 0.05).2 week survival rate in high crystal glue ratio group was lower than that in microtek glue ratio group and low crystal glue ratio group [34.2％(13/38)vs.86.7％ (26/30),57.7％(15/26)],there was significant difference between high crystal glue ratio group and microtek glue ratio group (P ＜ 0.05),but there was no significant difference between high crystal glue ratio group and low crystal glue ratio group(P ＞ 0.05).There was no significant difference in 2 week survival rate between low crystal glue ratio group and microtek glue ratio group(P ＞ 0.05).Conclusion In early SAP patients should follow the appropriate crystal glue ratio controlled fluid resuscitation,reduce fluid retention and improve the cure rate,and the use of microtek glue ratio controlled fluid resuscitation strategy is best. Key words: Pancreatitis, acute necrotizing; Resuscitation ; Prognosis; Crystal glue ratio