The clinical value of early mechanical ventilation in treatment of patients with severe acute pancreatitis

Objective To study the effect of early mechanical ventilation in treatment of patients with severe acute pancreatitis(SAP). Methods Fifty-two patients with SAP admitted in the First People's Hospital of Zhaoqing from January 2010 to January 2015 were randomly allocated into two groups(n=26), early mechanical ventilation group(observation group) and conventional mechanical ventilation group(control group). Patients in the observation group treated with early lung protective ventilation when PaO2<13.3kPa.Patients in the control group treated without mechanical ventilation untill PaO2<8kPa.The symptoms, the extent of inflammatory reaction, the severity of lung lesions and the mortality of two groups were compared through monitoring vital signs, abdominal circumference, APACHE Ⅱ score, bladder pressure, oxygenation index(PaO2/FiO2), C reactive protein(CRP), procalcitonin(PCT), hospital stay and mortality. Results No statistically significant differences in the APACHE II score, bladder pressure, oxygenation index, CRP and PCT in two groups before treatment were observed(P>0.05). The APACHEⅡ score (12.8±7.6)points, bladder pressure (14.9±7.9)cmH2O, CRP (48.8±30.1)mg/L, PCT (1.25±0.55)μg/L, mortality (3.84%) of the observation group after treatment were significantly lower than those of the control group(t=2.057, 2.091, 3.252, 2.697, χ2=4.305, all P<0.05), while the oxygenation index in the observation group [(300.0±34.9)mmHg] was significantly higher than that in the control group [(278.1±32.8)mmHg], the difference of the two groups was statistically significant(t=3.322, P<0.05). Conclusion Early lung protective ventilation is safe and effective for treatment of the patients with SAP. Key words: Severe acute pancreatitis(SAP); Mechanical ventilation; Lung protective ventilation; Acute respiratory distress syndrome (ARDS); Multiple organ dysfunction syndrome (MODS)