THE MECHANISM OF ARTERIAL HYPOXIA OCCURRING IN ACUTE-PANCREATITIS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 49  (194) , 151-163
Abstract
Respiratory function was measured in 14 patients with acute pancreatitis, none of whom had a previous history of cardiac or respiratory disease. Their mean age was 40 yr, mean PaO2 [arterial partial pressure of O2] on admission, 11 kPa [kiloPascal unit] and all had normal chest radiographs at that time. Arterial hypoxia was a common development and the mean PaO2 at the time of most severe hypoxia was 8.5 kPa with the lowest individual recording 4.9 kPa. Daily arterial blood gas monitoring, dynamic ventilatory tests and measurements of lung volume, transfer factor, closing volume, right to left shunts and studies of gas exchange were performed. The major abnormality apparently responsible for arterial hypoxia was right-to-left shunting. Seven patients developed radiological abnormalities, 5 of whom had pleural effusions. Five patients showed a mild restriction in lung volume, but there were no major consistent abnormalities of dynamic ventilatory tests, transfer factor or closing volumes. Small airway closure in dependent parts of the lung and less certainly loss of surfactant are unlikely to be major factors in the etiology of arterial hypoxia in patients with acute pancreatitis. All measurements were repeated at least 3 mo. after the acute illness. The respiratory insufficiency which occurs in this disease is possibly another variant of the adult respiratory distress syndrome.