Chong Yang
Hospital of the University of Electronic Science and Technology of China
Title: The effects of hydroxyethyl starch resuscitation on the early stage of severe acute pancreatitis
Biography
Biography: Chong Yang
Abstract
Objectives: This study aimed to compare the effects of hydroxyethyl starch (HES) 130/0.4 combined with crystalloid solution with those of crystalloid solution alone on inflammatory variables (IL-1, IL-6 and IL-8 and TNF-α), immunologic variables (CD4/8+ T cells), fluid balance (FB) negative (-) rate and renal function for severe acute pancreatitis (SAP) patients.
Methods: In this retrospective study, 59 patients received 6% HES 130/0.4 combined with crystalloid solution for fluid resuscitation (HES group), and 61 patients received only crystalloid solution simultaneously (control group) after admission. The serum values of IL-1, IL-6, IL-8 and TNF-α were measured on days 1, 2, 4 and 8. The peripheral blood CD4/8+ T lymphocyte rates, serum BUN and Cr values were measured on days 1, 4 and 8. The patients with FB(-) rates were recorded from days 1 to 8.
Results: Interaction term analysis (hospital stay and fluid resuscitation methods) based on mixed-effects regression model revealed significantly lower levels of IL-1 [risk ratio (RR): -0.406, P*: 0.041] and TNF-α (RR: -1.189, P*: 0.013) in the HES group compared with control group. The curve's RR difference was not significant for IL-6,CD4/8+ T lymphocyte rate, BUN and Cr values (P*>0.05). There was a significantly higher rate of patients with FB(-) from days 4 to 8 in the HES group (P<0.05).
Conclusion: HES 130/0.4 combined with crystalloid fluid resuscitation could decrease the IL-1 and IL-8 concentration, shorten the duration of positive fluid balance, and preserve patient’s immune status and renal function during the early stage of SAP.
