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

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 β_2-microglubuliri (Uβ_2-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, Uβ_2-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, Uβ_2-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.