Severe acute respiratory distress syndrome secondary to acute pancreatitis successfully treated with extracorporeal membrane oxygenation in three patients

Giles J. Peek, S. White, A. D N Scott, A. W. Hall, H. M. Moore, A. W. Sosnowski, R. K. Firmin

Research output: Contribution to journalArticle

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Abstract

Objective: To review three patients who underwent extracorporeal membrane oxygenation (ECMO) for acute respiratory failure secondary to pancreatitis. Summary Background Data: Severe acute pancreatitis often causes the acute respiratory distress syndrome (ARDS), and if ventilation is required, the mortality rate is more than 50%. If the ratio of PaO2/FiO2 falls below 100 mm Hg or the Murray lung injury score exceeds 3.5, the mortality rate rises to more than 80%. Three patients who have severe ARDS secondary to pancreatitis, who were hypoxic despite ventilation with 100% oxygen and high airway pressures, and who were all successfully treated with ECMO are reported here. The consensus here is that all three patients would have died without ECMO. Methods: Retrospective chart review and discussion of the literature. Results: Pre-ECMO data: mean PaO2/FiO2 59.3 mm Hg, mean Murray lung injury score 3.7, one patient administered 20 ppm inhaled nitric oxide. ECMO data: mean extracorporeal flow at initiation of ECMO 56.3 mL/kg per minute, all patients administered veno-venous ECMO, mean duration of ECMO 104.7 hours. All patients were successfully weaned from ECMO and extubated. One patient had a protracted hospital stay because of a colo-cutaneous fistula. All patients are long-term survivors. Conclusions: Extracorporeal membrane oxygenation proved an effective therapy for severe ARDS complicating acute pancreatitis. Extracorporeal membrane oxygenation was conducted without bleeding complications in these three patients.

Original languageEnglish (US)
Pages (from-to)572-574
Number of pages3
JournalAnnals of Surgery
Volume227
Issue number4
DOIs
StatePublished - Apr 1998
Externally publishedYes

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Severe Acute Respiratory Syndrome
Extracorporeal Membrane Oxygenation
Adult Respiratory Distress Syndrome
Pancreatitis
Lung Injury
Ventilation
Cutaneous Fistula
Mortality
Respiratory Insufficiency
Survivors
Length of Stay
Nitric Oxide

ASJC Scopus subject areas

  • Surgery

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Severe acute respiratory distress syndrome secondary to acute pancreatitis successfully treated with extracorporeal membrane oxygenation in three patients. / Peek, Giles J.; White, S.; Scott, A. D N; Hall, A. W.; Moore, H. M.; Sosnowski, A. W.; Firmin, R. K.

In: Annals of Surgery, Vol. 227, No. 4, 04.1998, p. 572-574.

Research output: Contribution to journalArticle

Peek, Giles J. ; White, S. ; Scott, A. D N ; Hall, A. W. ; Moore, H. M. ; Sosnowski, A. W. ; Firmin, R. K. / Severe acute respiratory distress syndrome secondary to acute pancreatitis successfully treated with extracorporeal membrane oxygenation in three patients. In: Annals of Surgery. 1998 ; Vol. 227, No. 4. pp. 572-574.
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