A strategy of fluid resuscitation in severe acute pancreatitis guided by oxygenation index combined with abdominal pressure

Objective To study the strategy of fluid resuscitation in severe acute pancreatitis (SAP) guided by oxygenation index combined with abdominal pressure. Methods From January 2012 to January 2014, 40 patients with SAP were included in the study. All the patients received a treatment protocol designed by the physician group in ICU using oxygenation index and abdominal pressure to guide treatment. These patients were divided into the positive fluid equilibrium and the negative fluid equilibrium groups according to the status of fluid equilibrium after 72 h of treatment. Results Among the 40 patients, 24 patients showed a positive fluid equilibrium after 72 h of fluid treatment. The average amount of fluid equilibrium was (5 191.8±1 596.5) ml, and the oxygenation index was significantly higher than that before treatment (296.5±60.0 vs 220.3±59.0, P 0.05), though there was no significant difference. 16 patients showed a negative fluid equilibrium. The average amount of fluid equilibrium was (-3 762.2±3 550.6) ml, and the oxygenation index was significantly higher than that before treatment (309.4±42.7 vs 198.5±47.6, P 0.05). Conclusions Using oxygenation index and abdominal pressure to guide treatment could result in effective fluid resuscitation in SAP. This treatment strategy effectively improved prognosis of patients with SAP. Key words: Severe acute pancreatitis; Fluid resuscitation; Oxygen index; Intra-abdominal hypertension