The risk factors for acute respiratory distress syndrome in patients with severe acute pancreatitis

Abstract

Acute respiratory distress syndrome (ARDS) is very common in patients with severe acute pancreatitis (SAP), the early interventions are essential to the prognosis of SAP patients. We aimed to evaluate the risk factors for ARDS in SAP patients, to provide insights into the management of SAP. SAP patients treated in our hospital from June 1, 2018 to May 31, 2020 were included. The characteristics and lab test results were collected and compared, and we conducted the logistic regression analyses were conducted to identify the potential risk factors for ARDS in patients with SAP. A total of 281 SAP patients were included finally, the incidence of ARDS in patients with SAP was 30.60%. There were significant differences on the respiratory rate, heart rate, APACHE II and Ranson score between 2 groups (all P < .05). And there were significant differences on the polymorphonuclear, procalcitonin, C-reactive protein, serum creatinine, albumin and PO2/FiO2 between 2 groups (all P < .05), and no significant differences on the K+, Na+, Ca+, white blood cell, neutrophils, urine and blood amylase, trypsin, lipase, alanine aminotransferase, aspartate aminotransferase, total bilirubin, triglyceride, total cholesterol, total bilirubin, fasting blood glucose, and pH were found (all P > .05). Respiratory rate >30/min (odds ratio [OR]: 2.405, 95% confidence interval[CI]: 1.163–4.642), APACHE II score >11 (OR: 1.639, 95% CI: 1.078–2.454), Ranson score >5 (OR: 1.473, 95% CI: 1.145–2.359), polymorphonuclear >14 × 109/L (OR: 1.316, 95% CI: 1.073–2.328), C-reactive protein >150 mg/L (OR: 1.127, 95% CI: 1.002–1.534), albumin ≤30 g/L (OR: 1.113, 95% CI: 1.005–1.489) were the independent risk factors for ARDS in patients with SAP (all P < .05). The incidence of ARDS in SAP patients is relatively high, and it is necessary to carry out targeted early prevention and treatment for the above risk factors.

The role of interleukin-4 and interleukin-5 Th2 cytokines in assessing severity and prognosis of acute pancreatitis

“…Overall, in this study 78 (32.5%) patients died during hospitalization, while in literature mortality rates as high as 30% [17]. The main cause of early death in AP patients is ARDS, 60% of our patients died in first 6 days of hospitalization mostly because of pulmonary complication [18]. In our study, according to the similarities between these two interleukins, their behavior in severe forms of acute pancreatitis is practically identical.…”

Predicting intensive care unit admission and death for COVID-19 patients in the emergency department using early warning scores

“…This is in accordance with data from other studies showing that hypercapnia is uncommon in COVID-19 patients, even in those admitted to ICU, 28 while hypoxia from early pulmonary involvement is the most common presentation feature. 4,29 NEWS-C, another modified version of NEWS, has recently been suggested for assessment of COVID-19 patients. 14 Age !65 years was added to NEWS-C as an independent risk factor based on recent reports in patients with influenza or other non-COVID infectious diseases.…”

“…2 Typical COVID-19 patients present with fever, myalgia, fatigue, and dry cough. 3,4 Severe cases progress to severe dyspnoea and hypoxemia within one week after the onset of symptoms. 3À5 In hospitalized COVID-19 patients, the prevalence of hypoxemic respiratory failure is around 20%, and more than 25% of them may require intensive care treatment.…”

Nomogram for the Prediction of In-Hospital Incidence of Acute Respiratory Distress Syndrome in Patients with Acute Pancreatitis

“…In some studies, factors such as immature granulocyte percentage and C-response protein were identified to be linked with ARDS occurrence in AP. (43,44) However, no study has been done for performing a nomogram in order to predict the incidence of ARDS in AP.…”