Influence Of GDFT By Inferior Vena Cava Respiratory Variations Index On Prognosis Of Severe Acute Pancreatitis

[Objective]To evaluate goal-directed fluid therapy(GDFT)by inferior vena cava respiratory variations index(IVCrvi)in patients with severe acute pancreatitis(SAP).[Method]The SAP patients in ICU were randomly divided into two groups,Group A used inferior vena cava diameter and IVCrvi by ultrasound to monitor GDFT for 72 hours,group B were given conventional fluid therapy for 72 hours.[Result]120 SAP patients were collected in two years,there were no significant differences between two groups at baseline.Comparing two groups with total fluid volume were A(14500±920 ml)vs B(12500±815)(P<0.01),After 72h treatment IVCrvi were much smaller than before in group A(60.66±10.10%vs 19.00±4.75%,P<0.01).The intra-abdominal pressure was lower in group A than in group B,Group A had lower APACHE ? score,lactate,Interleukin-6,C-reactive protein(P<0.05).Patients in group A had a reduced length of ICU stay and lower surgical decompression rate because of ACS.But ICU mortality,and 28d survival rate had no difference between two groups.[Conclusion]The IVCrvi by ultrasound may be a useful adjunct for GDFT in patients with SAP in the early stage.GDFT under the guidance of IVCrvi can improve hemodynamies and reduce the SIRS persistence time and the length of TCII stay.