The mechanisms of arterial hypoxia occurring in acute pancreatitis

doi:10.1016/S0300-2896(15)32437-6

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Se ha determinado la función pulmonar en 14 enfermos con pancreatitis aguda sin antecedentes cardiorespiratorios. Edad media de 40 años, la pO2 arterial al ingreso de 11 kPa y todos con radiografía de tórax normal. La hipoxia arterial es frecuente y llegó a 8,6 kPa con un caso de 4,9 kPs como máxima hipoxia. Además de la gasometría arterial se midieron test ventilatorios, medida de volúmenes pulmonares, TCO, volumen de cierre y shunt derecha-izquierda, con estudio de intercambio de gases. El análisis del efecto shunt y del intercambio gaseoso pone en evidencia que la mayor causa de hipoxia es el shunt derecha izquierda. Siete enfermos presentaron anomalías radiológicas, cinco con derrame pleural. Cinco enfermos tenían restricción pulmonar pero no se evidenciaron grandes cambios en los estudios ventilatorios, TCO o volumen de cierre. Por ello el cierre de vías periféricas en las partes dependientes o el efecto del surfactant parecen poco verosímiles como causas de la hipoxia en lapancreatitis aguda. Todos los test se repitieron tres meses después del cuadro agudo. La insuficiencia respiratoria en esta enfermedad puede ser una variante del síndrome de distress respiratorio del adulto.

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