Fluid therapy for pancreas-related massive abdominal bleeding in 28 patients

Objective To study the fluid therapy for pancreas-related massive abdominal bleeding. Methods Twenty-eight patients with pancreas-related massive abdominal bleeding admitted to our department from June 2008 to July 2010 were enrolled in this study.The total blood loss in them was approximately 2 000-3 000ml.The patients received fluid therapy at the time when they were sent to the ICU after their bleeding was controlled with surgical or non-surgical methods.The therapy was divided into two stages.When the mean arterial pressure was≥65mmHg,hemoglobin（Hb） was≥80g/L,and urine volume was 0.5-1ml/（kg·h） after the first stage therapy,blood pressure-elevating drugs were withdrawn.The second stage therapy was to achieve stable hemodynamics in order to prevent heart failure and pulmonary edema due to the absorption of interstitial fluid.The resuscitation,hemodynamics,blood gas analysis results and blood biochemical indexes were recorded. Results The time of the first and second stage therapy was 16.2±8.3h and 51.3±16.7h,respectively.The amounts of fluid infusion and blood transfusion were higher in the first stage therapy than in the second stage therapy（P＜0.05）.The urine output and coagulation function were much more improved after the second stage therapy than after the first stage therapy（P＜0.05）.Of the 28 patients,26 were cured and 2 died of severe infection and multiple organ failure. Conclusion Fluid therapy should be divided into different stages for pancreas-related massive abdominal bleeding.