Ann Hepatobiliary Pancreat Surg.  2019 Nov;23(4):359-364. 10.14701/ahbps.2019.23.4.359.

Acute respiratory distress-syndrome in the general complications of severe acute pancreatitis

• Ibadov RA
• Arifjanov
• Ibragimov
• Abdullajanov BR

• KMID: 2464325
• DOI: http://doi.org/10.14701/ahbps.2019.23.4.359

Abstract

BACKGROUNDS/AIMS
Improvement of efficiency of treatment of patients with severe acute pancreatitis (SAP), complicated by acute respiratory distress-syndrome (ARDS).
METHODS
The retrospective research of 67 SAP patients treated at the ICU of the NSSPCS has been conducted from 2008 to 2017. The basic criterion of patient inclusion was stable respiration impairment leading to hypoxia with PaOâ‚‚/FiOâ‚‚<300 mmHg that required mechanical ventilatory support.
RESULTS
Pancreatitis-associated ARDS was diagnosed in 36 cases (53.7%). The most frequent clinical form (15 cases) was ARDS of moderate severity (41.5%). The total mortality due to pancreatitis-associated ARDS made 44.5%. Close relationship between ARDS severity and mortality was evident. All lethal outcomes occurred due to progressing multiple organ dysfunction. No deaths were caused by uncontrollable hypoxemia.
CONCLUSIONS
The research has confirmed the leading role of pancreatitis-associated ARDS in development and high mortality rate of multiple organ dysfunction syndrome in SAP. Early recognition of the complication and application of ventilatory support techniques resulted in fast restoration of oxygenation and improvement of treatment efficiency.

Keyword

Severe acute pancreatitis; Acute respiratory distress-syndrome; Intensive therapy; Respiratory support

MeSH Terms

Anoxia
Humans
Mortality
Multiple Organ Failure
Oxygen
Pancreatitis*
Respiration
Retrospective Studies
Oxygen

Figure

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  Fig. 1 The initial X-ray and CT-scan of the chest of 48-year old patient with SAP complicated with pancreatitis-associated ARDS of moderate severity.

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  Fig. 2 Distribution of observations depending on the PaO2/FiO2 gain next day after the initiation of respiratory support.

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  Fig. 3 The X-ray and CT-scanning of the chest of 48-year old patient after 72 hours of respiratory support.

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  Fig. 4 Algorithm for the management of SAP.

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