Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study
机构：[1]Pancreatic Disease Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China,华中科技大学同济医学院附属协和医院[2]Organ Transplant Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, People’s Republic of China,四川省人民医院[3]School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People’s Republic of China,四川省人民医院[4]Key Laboratory of Geriatrics of Health Ministry, Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China,华中科技大学同济医学院附属协和医院[5]Surgical Oncology-Abdominal Department, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China,华中科技大学同济医学院附属协和医院[6]Microarray Core Facility, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America,[7]Center for Applied English Studies, the University of Hong Kong, Hong Kong, People’s Republic of China
Objective Many studies have indicated that intra-abdominal pressure (IAP) is positively correlated with central venous pressure (CVP) in severe cases. However, although elevated IAP is common in patients with severe acute pancreatitis (SAP), its relationship with CVP remains unclear. Our study aimed to investigate the association of IAP with CVP in early-phase SAP patients. Methods In total, 116 SAP patients were included in this retrospective study. On the first day of hospitalization, blood samples were collected for biochemical examination and cytokine concentration monitoring. Additionally, a urinary catheter and right subclavian vein catheter were inserted for IAP and CVP measurement, respectively. Other routine clinical data were also recorded. Results Within 24 hours after hospitalization, CVP fluctuated and increased with increasing IAP up to 15.7 mmHg (P = 0.054) but decreased with increasing IAP when the IAP was > 15.7 mmHg (P < 0.001). After adjusting for abdominal perfusion pressure (APP) and mean arterial pressure (MAP), a similar distribution was observed. An inverted U-shaped trend between IAP and CVP was also present in the groups classified according to the patient's sex, local complications, ascites, and serum amylase levels. Conclusions CVP and IAP have an inverted U-shaped relationship, with a peak at an IAP of 15.7 mmHg in the early phase of SAP. After this peak, CVP decreases as IAP increases. These results have crucial implications for clinical fluid resuscitation in SAP patients. In particular, because one CVP value might be correlated with different IAP values in patients with the same CVP, the volume of fluid needed might be different.
基金：
This work was supported by a grant from
the National Natural Science Foundation of China
(No. 81171840).
第一作者机构：[1]Pancreatic Disease Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China,[2]Organ Transplant Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, People’s Republic of China,[3]School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People’s Republic of China,
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通讯作者：
推荐引用方式(GB/T 7714)：
Chong Yang,Zhiyong Yang,Xinglin Chen,et al.Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study[J].PLOS ONE.2015,10(6):doi:10.1371/journal.pone.0128493.
APA：
Chong Yang,Zhiyong Yang,Xinglin Chen,Tao Liu,Shanmiao Gou...&Chunyou Wang.(2015).Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study.PLOS ONE,10,(6)
MLA：
Chong Yang,et al."Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study".PLOS ONE 10..6(2015)
