Novosti
Khirurgii
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indexed in Scopus



Year 2019 Vol. 27 No 3

ANESTHESIOLOGY-REANIMATOLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2019.3.300   |  

K.V. NIKITSINA

EARLY RESPIRATORY SUPPORT IN PATIENTS WITH ACUTE NECROTIC PANCREATITIS

Vitebsk State Medical University, Vitebsk,
The Republic of Belarus

Objective. To analyze the results of carrying out the early respiratory support in patients with acute necrotic pancreatitis.
Methods. 53 patients with acute necrotic pancreatitis in the fermentative phase are surveyed. Patients have been divided into 2 groups: 1 group (n=29) patients with standard intensive therapy; 2 group (n=24) patients who were subject to the mechanical ventilation of the lungs from the first day. Patients of both groups had a severe course of the disease (Ranson >4 points and APACHE II >11 points). The research was conducted in 3 stages: the 1st stage on admission to the intensive care unit; the 2nd stage 1 day afterwards, 3 stage after 4 days. The gases indicators of the arterial blood (pCO2, pO2, pO2/FiO2, lactate) were analyzed as well as the respiratory complains, intra-abdominal pressure, duration of respiratory therapy and mortality. The received results were compared in dynamics, between groups; their interrelation was analyzed.
Results. Carrying out of early respiratory support in patients with acute necrotic pancreatitis reduces the level of intra-abdominal pressure and normalizes the respiratory index, complains and the level of lactate. Indications for early respiratory support in patients with acute necrotic pancreatitis are the following: a severe course of the disease ≥4 points on scale Ranson and ≥11 points on APACHE II scale, intra-abdominal hypertension, low level of respiratory index <300 mm hg, high indicators of lactate >3.5 mmol/l.
Conclusions. Development of intra-abdominal hypertension in patients with acute necrotic pancreatitis aggravates the indicators of the respiratory status. Early mechanical ventilation of the lungs reduces the level of intra-abdominal pressure, normalizes the respiratory status indicators in the fermentative phase.

Keywords: acute necrotic pancreatitis, mechanical ventilation of lungs, respiratory index, respiratory complains, lactate, intra-abdominal hypertension
p. 300-306 of the original issue
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Address for correspondence:
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Anesthesiology and Resuscitation
With the Course of Advanced
Training and Retraining of Specialists.
Tel: +375 33 316-10-25,
e-mail: katarinaanaest@gmail.com,
Katsiaryna V. Nikitsina
Information about the authors:
Nikitsina Katsiaryna V, PhD, Associate Professor, Head of the Department of Anesthesiology and Resuscitation with the Course of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0003-4744-6838
Contacts | ©Vitebsk State Medical University, 2007