To evaluate the effect of fluid management under the guidance of pulse indicator continuous cardiac (PICCO) on patients with severe acute pancreatitis (SAP) and acute respiratory distress syndrome (ARDS).

A total of 57 patients with SAP and ARDS were enrolled in the study, and were divided into the treatment group (29 cases) and control group (28 cases). The patients in the control group were only treated by routine fluid infusion, while patients in the treatment group were treated by PICCO guided fluid infusion. The ARDS's incidence, the percentage of patients using vasoactive drugs, the intubation rate, the duration of invasive mechanical ventilation, the amount of fluid resuscitation within 0~<6 h, 6~<24 h, 24~<48 h, 48~72 h respectively, and the mortality rate were all recorded and compared between the two groups.

The severe ARDS's incidence[17.24% (5/29) vs. 42.85% (12/28), χ²=4.47, P=0.045] and intubation rate [6.90% (2/29) vs. 28.57% (8/28), χ²=4.63, P=0.041] were much lower, while the duration of invasive mechanical ventilation [(5.8 ± 2.7) d vs. (9.1 ± 3.7) d, t=4.01, P<0.001] was significantly shorter in the treatment group than those in the control group. But there was no statistical differences in the percentage of patients using vasoactive drugs (4/29 vs. 7/28, χ²=1.15, P=0.330) and mortality rate [10.34% (3/29) vs. 17.86% (5/28), χ²=0.47, P=0.670] between the two groups. The amount of fluid resuscitation within 6 hours in the treatment group increased significantly when compared with the control group (P<0.05), the levels of fluid resuscitation during 6~<24 h, 24~<48 h and 48~72 h in the treatment group were remarkably less than that in the control group (all P<0.05).

PICCO can guide the fluid resuscitation of patients with SAP and ARDS in the early stage, and avoid lung injury induced by blind rehydration.