[Effect of liquid resuscitation on homeostasis of patients with severe acute pancreatitis].

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 4594 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.

• Authors: Hai-bin Ni, Wei-qin Li, Lu Ke, Zhi-hui Tong, Xiao-fan Xu, Wei-wei Ding, Yao Nie
• Journal: Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue (Zhongguo Wei Zhong Bing Ji Jiu Yi Xue) Vol. 22 Issue 9 Pg. 522-4 (Sep 2010) ISSN: 1003-0603 [Print] China
• PMID: 20854729 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Acid-Base Imbalance
• Adult
• Aged
• Female
• Fluid Therapy
• Homeostasis
• Humans
• Male
• Middle Aged
• Pancreatitis, Acute Necrotizing (blood, physiopathology, therapy)
• Prospective Studies