DOI: https://doi.org/10.22141/2224-0586.16.3.2020.203159

Ways to improve the effectiveness of infusion therapy in patients with acute pancreatitis

O.Yu. Sorokina, L.S. Bielykh

Abstract


The data of patients with severe acute pancreatitis who were treated for the period from 2014 to 2018 were analyzed. It was determined that the course of severe acute pancreatitis was accompanied by dehydration, which was characterized by a 2-fold decrease in the circulating blood volume from the proper one, and was accompanied by hemoconcentration, electrolyte disorders, development of metabolic acidosis, and decreased SaO2a and SaO2v. Against the background of infusion therapy with balanced crystalloids, the normalization of serum Na+, Cl–, K+, pH, HCO3 levels was recorded after 24 hours on the background of a significant decrease in blood amylase, urine diastase and blood hematocrit. Conducting fluid resuscitation with balanced crystalloids under the control of systemic and central hemodynamic parameters during 1 day of intensive care was accompanied by a probable 27.3 and 26.1% increase in actual circulating blood volume in patients of groups 1 and 2, respectively, with an increase in cardiac output and cardiac index on the background of a decrease in vasoconstriction and normalization of SaO2a, which testified to the adequacy of intensive care for severe acute pancreatitis.

Keywords


severe acute pancreatitis; metabolic response; intensive care; fluid resuscitation; balanced crystalloids

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