Effect of early thoracic paracentesis drainage on acute lung injury in severe acute pancreatitis

Xuyang WANG; Zhangpeng WANG; Jun WU; Guangxu JING; Zhu HUANG; Hongyu SUN; Lijun TANG

doi:10.3969/j.issn.1001-5256.2023.07.018

Volume 39 Issue 7

Jul. 2023

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Article Navigation > Journal of Clinical Hepatology > 2023 > 39(7): 1633-1642

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Effect of early thoracic paracentesis drainage on acute lung injury in severe acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2023.07.018

Xuyang WANG^{1, 2},
Zhangpeng WANG^{2, 3},
Jun WU^{2, 4},
Guangxu JING^{2, 3},
Zhu HUANG^{2, 5},
Hongyu SUN^{2, 5
,
,
,},
Lijun TANG^{1, 2
,
,
,}

1.
College of Medicine, Chongqing Medical University, Chongqing 400016, China
2.
PLA Center of General Surgery, The General Hospital of Western Theater Command, Chengdu 610083, China
3.
College of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, China
4.
College of Medicine, Southwest Jiaotong University, Chengdu 610063, China
5.
Basic Medical Laboratory, The General Hospital of Western Theater Command, Chengdu 610083, China

Research funding:

National Natural Science Foundation of China (81772001);

National Clinical Key Subject of China (41732113)

More Information

Corresponding author: SUN Hongyu, shongyu2008@163.com(ORCID: 0000-0002-8587-0499); TANG Lijun, tanglj2016@163.com (ORCID: 0000-0001-6000-9515)
Received Date: 2022-11-21
Accepted Date: 2023-02-06
Published Date: 2023-07-20

Abstract

Abstract

Objective To investigate the effect of early thoracic paracentesis drainage for pleural effusion with a small or moderate volume on acute lung injury in patients with severe acute pancreatitis (SAP). Methods A retrospective analysis was performed for the clinical data of 107 patients with SAP who were admitted to The General Hospital of Western Theater Command from January 2015 to December 2021, and according to whether thoracic paracentesis drainage was performed within the first three days after admission, the patients were divided into thoracic paracentesis drainage group (TPD group with 51 patients) and non-thoracic paracentesis drainage group (N-TPD group with 56 patients).The two groups were compared in terms of laboratory markers and clinical outcome on days 5 and 10 after admission.The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Compared with the N-TPD group, the TPD group had a significantly shorter length of stay in the intensive care unit, a significantly shorter length of hospital stay, and significantly lower hospital costs (all P < 0.05), while there were no significant differences between the TPD group and the N-TPD group in mortality rate (9.8% vs 14.3%, χ²=0.502, P=0.478) and the incidence rate of sepsis (29.4% vs 44.6%, χ²=2.645, P=0.104).The TPD group had a significant reduction in the incidence rate of acute respiratory distress syndrome (ARDS)(χ²=6.038, P=0.043), as well as a significantly lower incidence rate of moderate ARDS than the N-TPD group (7.8% vs 21.4%, χ²=3.874, P=0.049).Compared with the N-TPD group, the TPD group had a significantly lower rate of use of mechanical ventilation (35.3% vs 57.2%, χ²=6.735, P=0.034) and a significantly lower proportion of patients receiving invasive mechanical ventilation (9.8% vs 26.8%, χ²=5.065, P=0.024).Compared with the N-TPD group, the TPD group had a significantly lower incidence rate of pulmonary infection (23.5% vs 42.9%, χ²=4.466, P=0.035) and a significantly shorter duration of systemic inflammatory response syndrome (11.2±5.0 days vs 16.8±4.7 days, t=5.949, P < 0.001).Compared with the N-TPD group, the TPD group had significantly better laboratory markers (high-sensitivity C-reactive protein, interleukin-1, interleukin-6, interleukin-8, tumor necrosis factor-α, arterial partial pressure of oxygen, oxygen saturation, and oxygenation index) and incidence rate of respiratory failure on days 5 and 10 after admission (all P < 0.05).On day 10 after admission, the TPD group had significantly better APACHE Ⅱ score and modified Mashall score than the N-TPD group (both P < 0.05). Conclusion For SAP patients with a small or moderate volume of pleural effusion, early thoracic paracentesis drainage can effectively improve acute lung injury, alleviate systemic inflammatory response, shorten the length of hospital stay, and reduce hospital costs.
- Pancreatitis,
- Pleural Effusion,
- Drainage,
- Acute Lung Injury,
- Systemic Inflammatory Response Syndrome

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References(43)

References

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Effect of early thoracic paracentesis drainage on acute lung injury in severe acute pancreatitis

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