Effect of epinephrine on blood pressure,heart rate and renal function in the patients with severe acute pancreatitis complicated with septic shock  

作　　者：熊东方 侯立朝 杨继庆 王雅 黄怡 熊利泽 巩固 陈绍洋 陈敏 胡文能 

机构地区：[1]Department of Anesthesiology Xijing Hospital,Fourth Military Medical University [2]Department of Biomedical Engineering Fourth Military Medical University

出　　处：《Journal of Medical Colleges of PLA(China)》2006年第6期393-396,共4页中国人民解放军军医大学学报（英文版）

基　　金：Supported by the National Natural Science Fundation of China(No. 30471675);the Topic of Tackle Key Problems in Science and Technology of Shaanxi Province(No. 2004K17G15).

摘　　要：Objective： To retrospectively study the effects of epinephrine on blood pressure, heart rate as well as renal function in the patients with severe acute pancreatitis complicated with septic shock. Methods： Twenty-five patients with severe acute pancreatitis complicated with septic shock were divided into 3 groups according to the biggest infusing rate of epinephrine used, with the infusing rate of 0.01-0.05, 0.06-0.10, 〉0.10 μg/kg·min in group A （n=9）, B （n=8） and C （n=8）, respectively. Mean arterial blood pressure （MAP）, heart rate （HR）, urine output, blood urea nitrogen （BUN）, creatinine （CRE）, urine albumin （U-ALB） and urine β2-microglubulin （Uβ2-MG） as well as APACHE Ⅲ scoring were recorded in all the patients. Results： Before anti-shock therapy was given, hypotension, tachycardia, oliguria as well as the abnormal levels of CRE, BUN, U-ALB, Uβ2-MG and APACHE Ⅲ scoring occurred in all the 25 patients. With anti-shock therapy, MAP, HR, urine output and BUN, CRE in the patients from the 3 groups gradually returned to normal （P〈0.01 vs before anti-shock therapy）, and U-ALB, Uβ2-MG output and APACHE Ⅲ scoring also restored but still remained abnormal （P〈0.01 vs before anti-shock therapy）. Conclusion： The first goal to treat the patients with severe acute pancreatitis complicated with septic shock should be restoring the organ blood supply. Based on volume resuscitation, epinephrine and other vasoactive drugs could be combined to maintain circulatory stability and also could benefit the restoration of the renal function.Objective: To retrospectively study the effects of epinephrine on blood pressure, heart rate as well as renal function in the patients with severe acute pancreatitis complicated with septic shock. Methods :Twenty-five patients with severe acute pancreatitis complicated with septic shock were divided into 3 groups according to the biggest infusing rate of epinephrine used, with the infusing rate of 0. 01-0. 05, 0. 06-0. 10, >0. 10μg/kg·min in group A (n = 9), B (n = 8) and C (n = 8), respectively. Mean arterial blood pressure (MAP), heart rate (HR), urine output, blood urea nitrogen (BUN), creatinine (CRE), urine albumin (U-ALB) and urineβ2-microglubulin (Uβ2-MG) as well as APACHE III scoring were recorded in all the patients. Results: Before anti-shock therapy was given, hypotension, tachycardia, olig-uria as well as the abnormal levels of CRE, BUN, U-ALB, Uβ2-MG and APACHE III scoring occurred in all the 25 patients. With anti-shock therapy, MAP, HR, urine output and BUN, CRE in the patients from the 3 groups gradually returned to normal (P<0. 01 vs before anti-shock therapy), and U-ALB, Uβ2-MG output and APACHE H scoring also restored but still remained abnormal (P<0. 01 vs before anti-shock therapy). Conclusion: The first goal to treat the patients with severe acute pancreatitis complicated with septic shock should be restoring the organ blood supply. Based on volume resuscitation, epinephrine and other vasoactive drugs could be combined to maintain circulatory stability and also could benefit the restoration of the renal function.

关 键 词：EPINEPHRINE severe acute pancreatitis septic shock CIRCULATION renal function 

分 类 号：R576[医药卫生—消化系统]