title: The effects of fluid resuscitation according to PiCCO on the early stage of severe acute pancreatitis.
abstract: OBJECTIVE
  To evaluate the therapeutic effect of early fluid resuscitation under the guidance of Pulse indicator Continuous Cardiac Output (PiCCO) on patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  Clinical data of 18 SAP patients (the study group), who had undergone fluid resuscitation under the guidance of PiCCO from October 2011 to October 2013, were analyzed prospectively. Clinical data of 25 cases (control group) who had undergone fluid resuscitation without the guidance of PiCCO from January 2009 to September 2011 were collected. Then, retrospective and prospective case-control study was carried out.
  
  
  RESULTS
  During the first 6 h, 0-24 h, 24-48 h, and 0-72 h of admission, the study group received more volume of fluid than the control group. There were significantly faster decline of APACHE II score and the value of blood lactate in study group, as well as the length of ICU stay and the proportion of renal failure at 72 h of admission. According to the 2012 Atlanta classification, six cases in study group turned into moderate SAP (33.30%), significantly higher than the control group (8.00%) (p = 0.0049). The volume of fluid infusion and clinical parameters were linearly relative.
  
  
  CONCLUSIONS
  The PiCCO device may be a useful adjunct for fluid resuscitation monitoring in patients with SAP in the early stage. Early fluid resuscitation under the guidance of PiCCO can improve tissue perfusion, reduce the SIRS persistence time and the length of ICU stay. This program did not increase the risk of respiratory failure and influence the mortality.
authors.affiliation: Department of Intensive Care Unit, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Intensive Care Unit, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China.
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Lu
authors.affiliation: Ultrasonic Diagnosis Department, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China. Electronic address: zhangxsh@mail.HF.AN.cn.
authors.forename: Xin-Shu
authors.initials: XS
authors.lastname: Zhang
authors.affiliation: Department of Intensive Care Unit, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China. Electronic address: xp_geng@163.net.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Geng
authors.affiliation: Department of Intensive Care Unit, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Cao
authors.affiliation: Department of Intensive Care Unit, The Second Affiliated Hospital to Anhui Medical University, Heifei 230601, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000628:therapy*; D011446:Prospective Studies; D012151:Resuscitation / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: APACHE II score; Fluid resuscitation; ICU; Pulse indicator continuous cardiac output; SIRS; Severe acute pancreatitis