Liu Xucmin, Umar Ali, Pan Cheng`en, Liu Qingguang, Wang Zifa.
The Diagnosis and Treatment of Lung Injury following Severe Acute Pancreatitis.
J Rawal Med Coll Jan ;6(1):4-7.

Background: To evaluate the influence of large doses of dexamethasone plus dextran and/or salviae miltiorrhizae in ameliorating microcirculation in severe acute pancreatitis (SAP) with special reference to treating and preventing lung injury including ARDS. Method: Sixty-nine patients admitted with SAP at the XJTU First Affiliated Hospital, China from 1994 to 2000 were studied. The initial 53 received conventional treatment for SAP. The remaining 16 were also given high dose dexamethasone parenterally (30 to 60mg daily) plus dextran and/or salviae miltiorrhizae in addition to routine therapy. Any evidence of lung injury was especially noted. Treatment was initiated as early as possible. Results: Of the 53 patients receiving conventional treatment, 25 showed evidence of lung injury and 14 went on to develop ARDS. Among the 16 patients receiving dexamethasone in addition, 6 showed evidence of lung injury and two developed ARDS. Overall mortality was 29% (20 patients) of which 17 patients belonged to the conventionally treated group. ARDS mortality in this group was 26.4% whereas it was 12.5% in those who received dexamethasone in addition to conventional treatment. Conclusions: High doses of dexamethasone in early stage treatment and in ameliorating microcirculation are beneficial to treat lung injury and ARDS following SAP and can reduce the mortality rate.

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