The effect of hypertonic saline on hemodynamics and inflammatory cytokines in severe acute pancreatitis

YANG Wen-xiong; KANG Li-min; ZHENG Yong; ZHOU Ya-hao; WANG A-yong; SHI Hong-ning; ZHAO Ying-hong; WANG Yue-qiu; HUANG Qiong

doi:10.3760/cma.j.issn.1673-4777.2012.01.024

Abstract：Objective To study the effect of hypertonic saline treatment on hemodynamics and inflammatory cytokines in severe acute pancreatitis.Methods A total of 57 severe acute pancreatitis were randomized into hypertonic saline group ( n =27 ) and control group ( n =28 ).Hypertonic saline group received intravenously 4 ml/kg of 7.5％ hypertonic saline and control group received 0.9％ physiological saline after admission.Blood and urine amylase levels and WBC count were analyzed before admission and 1,3,7 and 14 days after treatment.The blood plasma endotoxin,tumor necrosis factor( TNF)-α,interleukin( IL)-10 levels and mean arterial pressure(MAP),heart rate(HR),central venous pressure(CVP) were measured at the same time.Results One and seven days after treatment,the MAP and CVP in hypertonic saline group were significantly higher than those in the control group [(130±48)mmHgvs (104±43)mm Hg,(129±36)mm Hgvs (104±31)mm Hg;(8.39±2.91)cm H2Ovs (5.92 ±2.84)cm H2O,(8.82 ±2.69)cm H2O vs (6.41 ±3.10)cm H2O,P ＜0.05].The HR in hypertonic saline group was significantly lower than that in the control group after treatment of 3 days [ (98 ± 19) times/min vs ( 126 ±27)times/min,P ＜0.05].After treatment of 14 days,the serum levels of plasma endotoxin,TNF-α,IL-10 in hypertonic saline group were significantly lower than those in the control group[ (2.70 ±0.13) ng/L vs (3.25 ± 0.30) ng/L,(30.13 ±8.12) ng/L vs (313.42 ± 144.35) ng/L,(586.45 ± 14.54) ng/L vs (412.72 ±48.55) ng/L,P＜0.01 or P ＜0.05].Conclusions Hypertonic can improve the hemodynamics of severe acute pancreatitis patients and reduce endotoxin, TNF-α level in plasma. Hypertonic has an positive effect on severe acute pancreatitis.