Hydroxyethyl Starch Resuscitation Reduces the Risk of Intra-Abdominal Hypertension in Severe Acute Pancreatitis
Hydroxyethyl Starch Resuscitation Reduces the Risk of Intra-Abdominal Hypertension in Severe Acute Pancreatitis
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DOI：
10.1097/mpa.0b013e3182217f17
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发表时间：
2011-11-01
期刊：
影响因子：
2.9
通讯作者：
Li, Quan-Sheng
中科院分区：
文献类型：
--
作者：
Du, Xiao-Jiong;Hu, Wei-Ming;Li, Quan-Sheng
目的：探讨羟乙基淀粉(HES)对重症急性胰腺炎(SAP)早期腹内压(IAP)的影响。方法：41例SAP患者随机分为HES组(n=20)和林格氏乳酸盐(RL)组(n=21)。各组分别给予6%HES 130/0.4溶液和不含胶体的RL液治疗8d。主要终点是IAP。次要终点为液体平衡、主要脏器并发症、急性生理学与慢性健康评估II评分、血清C-反应蛋白、白介素6、白介素8水平。在HES组，IAP在2~7天内显著降低，接受机械通气的患者较少(15.0%对47.6%)。HES组较RL组更早出现液体负平衡(2.5+/-2.2天vs4.0+/-2.5天)。结论：SAP早期应用HES液体复苏可降低腹内高压的风险，减少机械通气的使用。
Objectives: This study aimed to address whether hydroxyethyl starch (HES) is beneficial for intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) in early stages.Methods: Forty-one patients with SAP were randomized to HES group (n = 20) and the Ringer's lactate (RL) group (n = 21). The groups received 6% HES 130/0.4 for 8 days and RL solution without colloid, respectively. The primary end point was the IAP. The secondary end points were fluid balance, major organ complications, the Acute Physiology and Chronic Heath Evaluation II score, and the serum levels of C-reactive protein, interleukin-6, and interleukin-8.Results: The characteristics of baseline data were similar in the 2 groups. In the HES group, the IAP was significantly lower in 2 to 7 days, and fewer patients received mechanical ventilation (15.0% vs 47.6%). A negative fluid balance was observed earlier in the HES group than in the RL group (2.5 +/- 2.2 vs 4.0 +/- 2.5 days).Conclusions: Fluid resuscitation with HES in the early stages of SAP can decrease the risk of intra-abdominal hypertension and reduce the use of mechanical ventilation.