Correlation of fluid resuscitation volume with intra-abdominal hypertension and renal injury in patients with severe acute pancreatitis / 第二军医大学学报

ABSTRACT

Objective To investigate the correlation of fluid resuscitation volume with intra-abdominal hypertension (IAH) and renal injury in patients with severe acute pancreatitis (SAP). Methods Totally 60 patients with SAP from our ICU were recruited in the present study. The intra-abdominal pressure (IAP) was measured by method AbViser. The patients were divided into the following 3 groups according to the different of IAP the normal group, IAH group and abdominal compartment syndrome (ACS) group. The general information, mortality rate, fluid resuscitation volumes and renal injury were analyzed and compared in the 3 groups. Results (1) The incidence rates of IAH and ACS in our study were 31.67%(19/60) and 11.67% (7/60), respectively. The mortality rates of normal group, IAH group and ACS group were 5.88%(2/34), 21.05%(4/19) and 57.14%(4/7), respectively. The mortality rate of ACS group was significantly higher than that of normal group (P=0.007). (2) The fluid balance volumes of normal group, IAH group and ACS group were (4 350±892), (5 512±1 246) and (5 974±1 765) mL, respectively, with significant differences found among the 3 groups (P<0.001); the total cumulative fluid volumes of the 3 groups were (8 530±2 384), (9 403±2 064) and (13 172±2 409) mL, respectively, also with significant differences found among the 3 groups (P<0.001). ACS group had the highest fluid balance and total cumulative fluid volumes in the first 3 days. (3) There were significant differences in the levels of blood creatinine and urea nitrogen among the 3 groups (P<0.001). The levels of blood creatinine and urea nitrogen of ACS group was significantly higher than those of normal group and IAH group (P<0.05). Conclusion The cumulative fluid of the first 3 days is associated with IAH and even ACS in pateints with SAP, and IAH can further lead to renal injury in patients with SAP.