Effect of infusion therapy volume on endothelial dysfunction in patients with acute severe pancreatitis
https://doi.org/10.24884/2078-5658-2025-22-6-80-85
Abstract
The objective was to study the effect of the volume of infusion therapy on the level of endothelial dysfunction markers in patients with acute severe pancreatitis.
Materials and methods. The study involved 46 patients with acute severe pancreatitis aged 45 (35; 59) years. Depending on the daily infusion volume, all patients were divided into 2 groups: those with a daily infusion volume of more than 5,000 ml and those with a daily infusion volume less than 5,000 ml. The study was performed in 7 stages during 14 days of the early phase of the disease. The dynamics of markers of endothelial dysfunction (syndecan-1, vascular endothelial growth factor and intercellular adhesion molecules) and their differences between the groups were analyzed.
Results. In patients of group 1 with an infusion volume of more than 5,000 ml/day, by day 14 of the disease, the levels of vascular endothelial growth factor and syndecan-1 increased from 343.91 (194.81; 812.94) pg/ml to 1,597.21 (980.0; 1,622.55) pg/ml (p = 0.037) and from 1.54 (0.50; 5.99) ng/ml to 6.32 (5.05; 6.49) ng/ml (p = 0.036), respectively, the level of intercellular adhesion molecules decreased from 84.10 (61.31; 105.36) ng/ml to 55.15 (46.44; 70.21) ng/ml (p = 0.005). In patients of group 2 with an infusion volume of less than 5,000 ml/day, a stable level of all the above-mentioned markers of endothelial dysfunction were observed throughout the early phase of the disease. The mortality rate in group 1 was 45%, while in group 2 it was 17% (p = 0,015).
Conclusion. In patients with acute severe pancreatitis with an initial infusion volume of more than 5,000 ml/day, an increase in vascular endothelial growth factor, syndecan-1, and a decrease in the level of intercellular adhesion molecules were noted. An infusion volume of less than 5,000 ml/day has less damaging effect on the endothelium, which is accompanied by a stable level of the above-mentioned markers of endothelial dysfunction.
About the Authors
E. V. Nikitina
Vitebsk State Order of Peoples’ Friendship Medical University
Belarus
Belarus
Nikitina Ekaterina V., Cand. of Sci. (Med.), Associate Professor, Head of the Department of Anesthesiology and Intensive Care with the course of FAT and Staff and SR
27, Frunze str., Vitebsk, 210009
G. V. Ilukevich
Belarusian State Medical University
Belarus
Belarus
Ilukevich Georgy V., Dr. of Sci. (Med.), Professor
83, Dzerzhinskogo str., Minsk, 220083
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For citations:
Nikitina E.V., Ilukevich G.V. Effect of infusion therapy volume on endothelial dysfunction in patients with acute severe pancreatitis. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2025;22(6):80-85. (In Russ.) https://doi.org/10.24884/2078-5658-2025-22-6-80-85
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