Abstract
To clarify the characteristics of pulmonary dysfunction (PD) complicating severe acute pancreatitis (SAP), we analyzed 105 patients with SAP. The incidence of PD was 50%. The severity scores on admission and the frequency of necrotizing pancreatitis were significantly higher in patients with PD. Among the blood biochemical parameters on admission, BE, BUN, Cr, BS, LDH, CRP, lymphocyte count, Ca, total protein, and PMN-elastase were significantly different between patients with PD and those without PD. The incidence of infection (48%) and the mortality rate (58%) were significantly higher in patients with PD. Moreover, the incidence of infection (56%) and the mortality rate (68%) were significantly higher in patients with PD together with multiple organ dysfunction syndrome (MODS) compared with PD alone. In patients with PD, the prognostic factors on admission were AST, ALT, total bilirubin, Cr, Ca, and LDH. On admission in patients with PD, early PD, and late PD, the frequency of pancreatic surgery was 47%, 0%, 75%, respectively and the mortality rates were 63%, 10%, 83%, respectively. In PD of every phase, the mortality rates were higher in patients with PD together with MODS. These results suggest that systemic intensive care including a strategy against infection is needed in patients with PD together with MODS.
