Document Detail


The pathogenesis of pulmonary edema in acute pancreatitis.
MedLine Citation:
PMID:  1101836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute pulmonary edema appeared 3 or more days after the onset of acute pancreatitis in 7 patients, an approximate incidence of 8%. The severity of pancreatitis in these patients was characterized by massive requirements for intravenous colloid and by marked hypocalcemia. In addition, at least 5 of the 7 patients had very high serum levels of triglycerides at the time of hospital admission. Hemodynamic studies during pulmonary edema showed normal central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, and pulmonary vascular resistance. Cardiac index was appropriately elevated. Respiratory treatment, consisting of endotracheal intubation and controlled ventilation with PEEP, was successful in allowing reversal of the pulmonary injury and recovery of respiratory function within 1-2 weeks in all cases. Two patients died later from pancreatic abscesses. The findings indicate that a distinct form of pulmonary injury may occur in acute pancreatitis, characterized by loss of integrity of the alveolar-capilllary membrane, leading to pulmonary edema. The mechanism of injury is not known but may be caused by circulating free fatty acids, phospholipase A, or vasoactive substances. The pulmonary membrane lesion appears to heal during the period of intensive respiratory support.
Authors:
A L Warshaw; P B Lesser; M Rie; D J Cullen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  182     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1975 Oct 
Date Detail:
Created Date:  1975-12-20     Completed Date:  1975-12-20     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  505-10     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Female
Humans
Hyperlipidemias / complications
Male
Middle Aged
Pancreatitis / complications*
Positive-Pressure Respiration
Pulmonary Edema / etiology*,  therapy
Respiratory Function Tests
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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