Objective To investigate the relationship between early fluid management and the conversion rate to surgery in patients with sever acute pancreatitis( SAP) .
Methods The patients with SAP admitted in ICU in West China Hospital from July 2005 to June 2010 were retrospectively analyzed. They were divided into four groups according to the quartile of the accumulated fluid balance in the first three days after admission in ICU(  lt; 25% , 25% ～50% , 50% ～75% , and  gt; 75% , respectively) . The major demographic data, clinical characteristics, mortality, and conversion rate to surgery were evaluated respectively.
Results 208 patients were enrolled. For each quartile, the conversion rate to surgery decreased at first, and then increased along with the increase of the accumulated fluid balance. Significant difference existed between the second quartile with the lowest conversion rate to surgery and other three quartiles ( P  lt; 0. 05) . Differences were also found in mortality and the score of acute physiology and chronic health evaluation Ⅱ( APACHEⅡ) on 24th and 48th hour between the first three quartiles and the last quartile with the highest mortality and APACHⅡ score( P  lt;0. 05) . However, sex ratio, age, Ranson criteria, and the score of sequential organ failure assessment( SOFA) did not have significant differences among each quartile( P  gt; 0. 05) .
Conclusion Fluid management in early stage can influence conversion rate to surgery and mortality in patients with SAP.

Citation： CHEN Yao,YIN Wanhong,WANG Bo,DENG Yiyun,KANG Yan,LIU Jin.. The Relationship Between Early Fluid Management and Conversion Rate to Surgery in Patients with Severe Acute Pancreatitis. Chinese Journal of Respiratory and Critical Care Medicine, 2012, 11(6): 576-579. doi: Copy