Clinical Effect of Noninvasive Positive Pressure Ventilation on Severe Acute Pancreatitis Combined with Acute Lung Injury in Emergency_West China Medical Journal

Authors：

 YangYong ,  LiuJining , LiuDan , LüRuqi

Emergency Department, Central Hospital of Mianyang, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

LiuJining, Email: cqydg@126.com

Keywords：

Emergency treatment; Noninvasive positive pressure ventilation; Severe acute pancreatitis; Acute lung injury; Hospital stay; Mortality

DOI：

10.7507/1002-0179.201600276

Video：

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Objective To analyze the effect of noninvasive positive pressure ventilation (NPPV) on the treatment of severe acute pancreatitis (SAP) combined with lung injury [acute lung injury (ALI)/acute respiratory distress syndrome (ARDS)] in emergency treatment. Methods Fifty-six patients with SAP combined with ALI/ARDS treated between January 2013 and March 2015 were included in our study. Twenty-eight patients who underwent NPPV were designated as the treatment group, while the other 28 patients who did not undergo NPPV were regarded as the control group. Then, we observed patients' blood gas indexes before and three days after treatment. The hospital stay and mortality rate of the two groups were also compared. Results Before treatment, there were no significant differences between the two groups in terms of pH value and arterial partial pressure of oxygen (PaO₂) (P>0.05). Three days after treatment, blood pH value of the treatment group and the control group was 7.41±0.07 and 7.34±0.04, respectively, with a significant difference (P＜0.05); the PaO₂ value was respectively (60.60±5.11) and (48.40±3.57) mm Hg (1 mm Hg=0.133 kPa), also with a significant difference (P＜0.05). The hospital stay of the treatment group and the control group was (18.22±3.07) and (23.47±3.55) days with a significant difference (P＜0.05); and the six-month mortality was 17% and 32% in the two groups without any significant difference (P>0.05). Conclusion It is effective to treat patients with severe acute pancreatitis combined with acute lung injury in emergency by noninvasive positive pressure ventilation.

Citation： YangYong, LiuJining, LiuDan, LüRuqi. Clinical Effect of Noninvasive Positive Pressure Ventilation on Severe Acute Pancreatitis Combined with Acute Lung Injury in Emergency. West China Medical Journal, 2016, 31(6): 1028-1030. doi: 10.7507/1002-0179.201600276 Copy

1.	Ogawa M, Hirota M, Hayakawa T, et al. Development and use of a new staging system for severe acute pancreatitis based on a nationwide survey in Japan[J]. Pancreas, 2002, 25(4): 325-330.
2.	Surbatovic M, Jovanovic K, Radakovic S, et al. Pathophysiological aspects of severe acute pancreatitis-associated lung injuryJ[]. Srp Arh Celok Lek, 2005, 133(1/2):76-81.
3.	De Campos T, Deree J, Coimbra R. From acute pancreatitis to end-organ injury: mechanisms of acute lung injury[J]. Surg Infect (Larchmt), 2007, 8(1): 107-120.
4.	刘学民, 潘承恩, 刘青光, 等. 重症急性胰腺炎胰腺损伤与肺损伤的关系[J]. 西安交通大学学报: 医学版, 2005, 26(4): 371-373.
5.	彭加英, 李先全, 范红英. 超早期无创正压通气治疗重症急性胰腺炎所致肺损伤疗效观察[J]. 医学理论与实践, 2010, 23(5): 502-504.
6.	中华医学会科学分会胰腺外科学组. 重症急性胰腺炎诊治草案[J]. 中华普通外科杂志, 2001, 16(11): 699-700.
7.	中华医学会呼吸病学分会. 急性肺损伤/急性呼吸窘迫综合征的诊断标准(草案) [J]. 中华结核和呼吸杂志, 2000, 23(4): 203.
8.	张海瑛, 臧泽林, 雷霆, 等. 无创正压通气对重症急性胰腺炎合并 ALI/ARDS的治疗价值[J]. 西部医学, 2010, 4(22): 644-645.
9.	尹辉明, 米允仕, 许燕山, 等. 双水平无创正压通气治疗重症急性胰腺炎合并急性肺损伤20例[J]. 中国危重病急救医学, 2004, 16(12): 763-763.
10.	Imai Y, Kawano T, Miyasaka K, et al. Inflammatory chemical mediators during conventional ventilation and during high frequency oscillatory ventilation[J]. Am J Respir Crit Care Med, 1994, 150(6 Pt 1): 1550-1554.
11.	Takata M, Abe J, Tanaka H, et al. Intraalveolar expression of tumor necrosis factor-alpha gene during conventional and high-frequency ventilation[J]. Am J Respir Crit Care Med, 1997, 156(1): 272-279.
12.	陈新, 陈瑞, 许睿, 等. 无创正压通气对急性肺损伤早期气体交换和呼吸应答的影响[J]. 当代医学, 2011, 17(31): 1-3.
13.	古满平, 丁福, 范晶. 无创正压通气在多发伤并发ALI/ARDS中的临床应用[J]. 重庆医科大学学报, 2010, 35(12): 1884-1887.
14.	熊艳, 袁月华, 洪武军, 等. 重症急性胰腺炎并发急性呼吸窘迫综合征的肺保护通气[J]. 中国综合临床, 2005, 21(3): 239-240.
15.	张鲁军. 无创机械通气在急性肺损伤治疗中的应用[J]. 齐鲁护理杂志, 2007, 13(20): 23-24.
16.	吴峰, 杨德春, 蒋田华, 等. 无创通气治疗重症急性胰腺炎并发 ALI/ARDS疗效探讨[J]. 中国民康医学, 2006, 18(22): 846-846.
17.	Yilmaz M, Gajic O. Optimal ventilator settings in acute lung injury and acute respiratory distress syndrome[J]. Eur J Anaesthesiol, 2008, 25(2): 89-96.
18.	余康敏, 王春友, 陈鑫. 中性粒细胞凋亡对急性胰腺炎相关性肺损伤的影响[J]. 中华急诊医学杂志, 2005, 14(9): 742-745.
19.	Hartwig W, Carter EA, Jimenez RE, et al. Neutrophil metabolic activity but not neutrophil sequestration reflects the development of pancreatitis-associated lung injury[J]. Crit Care Med, 2002, 30(9): 2075-2082.
20.	尹辉明, 杨晶, 杨宏亮, 等. 双水平无创正压通气早期治疗创伤后急性肺损伤/急性呼吸窘迫综合征[J]. 中国呼吸与危重监护杂志, 2007, 6(3): 219-220.
21.	刘丹, 周发春, 徐昉. 早期无创正压机械通气在治疗重症急性胰腺炎急性肺损伤中的应用价值研究[J]. 重庆医学, 2009, 38(20): 2528-2529.

1. Ogawa M, Hirota M, Hayakawa T, et al. Development and use of a new staging system for severe acute pancreatitis based on a nationwide survey in Japan[J]. Pancreas, 2002, 25(4): 325-330.
2. Surbatovic M, Jovanovic K, Radakovic S, et al. Pathophysiological aspects of severe acute pancreatitis-associated lung injuryJ[]. Srp Arh Celok Lek, 2005, 133(1/2):76-81.
3. De Campos T, Deree J, Coimbra R. From acute pancreatitis to end-organ injury: mechanisms of acute lung injury[J]. Surg Infect (Larchmt), 2007, 8(1): 107-120.
4. 刘学民, 潘承恩, 刘青光, 等. 重症急性胰腺炎胰腺损伤与肺损伤的关系[J]. 西安交通大学学报: 医学版, 2005, 26(4): 371-373.
5. 彭加英, 李先全, 范红英. 超早期无创正压通气治疗重症急性胰腺炎所致肺损伤疗效观察[J]. 医学理论与实践, 2010, 23(5): 502-504.
6. 中华医学会科学分会胰腺外科学组. 重症急性胰腺炎诊治草案[J]. 中华普通外科杂志, 2001, 16(11): 699-700.
7. 中华医学会呼吸病学分会. 急性肺损伤/急性呼吸窘迫综合征的诊断标准(草案) [J]. 中华结核和呼吸杂志, 2000, 23(4): 203.
8. 张海瑛, 臧泽林, 雷霆, 等. 无创正压通气对重症急性胰腺炎合并 ALI/ARDS的治疗价值[J]. 西部医学, 2010, 4(22): 644-645.
9. 尹辉明, 米允仕, 许燕山, 等. 双水平无创正压通气治疗重症急性胰腺炎合并急性肺损伤20例[J]. 中国危重病急救医学, 2004, 16(12): 763-763.
10. Imai Y, Kawano T, Miyasaka K, et al. Inflammatory chemical mediators during conventional ventilation and during high frequency oscillatory ventilation[J]. Am J Respir Crit Care Med, 1994, 150(6 Pt 1): 1550-1554.
11. Takata M, Abe J, Tanaka H, et al. Intraalveolar expression of tumor necrosis factor-alpha gene during conventional and high-frequency ventilation[J]. Am J Respir Crit Care Med, 1997, 156(1): 272-279.
12. 陈新, 陈瑞, 许睿, 等. 无创正压通气对急性肺损伤早期气体交换和呼吸应答的影响[J]. 当代医学, 2011, 17(31): 1-3.
13. 古满平, 丁福, 范晶. 无创正压通气在多发伤并发ALI/ARDS中的临床应用[J]. 重庆医科大学学报, 2010, 35(12): 1884-1887.
14. 熊艳, 袁月华, 洪武军, 等. 重症急性胰腺炎并发急性呼吸窘迫综合征的肺保护通气[J]. 中国综合临床, 2005, 21(3): 239-240.
15. 张鲁军. 无创机械通气在急性肺损伤治疗中的应用[J]. 齐鲁护理杂志, 2007, 13(20): 23-24.
16. 吴峰, 杨德春, 蒋田华, 等. 无创通气治疗重症急性胰腺炎并发 ALI/ARDS疗效探讨[J]. 中国民康医学, 2006, 18(22): 846-846.
17. Yilmaz M, Gajic O. Optimal ventilator settings in acute lung injury and acute respiratory distress syndrome[J]. Eur J Anaesthesiol, 2008, 25(2): 89-96.
18. 余康敏, 王春友, 陈鑫. 中性粒细胞凋亡对急性胰腺炎相关性肺损伤的影响[J]. 中华急诊医学杂志, 2005, 14(9): 742-745.
19. Hartwig W, Carter EA, Jimenez RE, et al. Neutrophil metabolic activity but not neutrophil sequestration reflects the development of pancreatitis-associated lung injury[J]. Crit Care Med, 2002, 30(9): 2075-2082.
20. 尹辉明, 杨晶, 杨宏亮, 等. 双水平无创正压通气早期治疗创伤后急性肺损伤/急性呼吸窘迫综合征[J]. 中国呼吸与危重监护杂志, 2007, 6(3): 219-220.
21. 刘丹, 周发春, 徐昉. 早期无创正压机械通气在治疗重症急性胰腺炎急性肺损伤中的应用价值研究[J]. 重庆医学, 2009, 38(20): 2528-2529.

West China Medical Journal

Clinical Effect of Noninvasive Positive Pressure Ventilation on Severe Acute Pancreatitis Combined with Acute Lung Injury in Emergency

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