[Invasive pulmonary monitoring in acute necrotizing pancreatitis. A decision aid for indications for surgery?].
From January 1986 to September 1988 16 patients with necrotizing forms of acute pancreatitis underwent invasive pulmonary monitoring at the Departments of General Surgery and Anesthesiology of Münster University Hospitals. Six patients had Stage II and ten Stage III disease according to the Mainz Clinical Classification for acute pancreatitis. Mortality was 37.5% in the reported series. Acute pancreatitis is characterized in cardiopulmonary terms by elevated levels for Cardiac Output (CO), Cardiac Index (CI) and Intrapulmonary Shunting (vAdmix), whereas Systemic Vascular Resistance (SVR) is significantly reduced. A decrease of SVR of more than 200 dyn s cm-5 may be an early indicator for a septic period, and, therefore, warrant operation.
Sulkowski
U
U
Klinik und Poliklinik für Allgemeine Chirurgie, Westfälischen Wilhelms-Universität Münster.
Strobel
M
M
Thülig
B
B
Pollmann
T
T
Meyer
J
J
D000006:Abdomen, Acute / Q000601:surgery; D000208:Acute Disease; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D003658:Decision Making, Computer-Assisted; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D009336:Necrosis; D010195:Pancreatitis / Q000150:complications / Q000601:surgery*; D011651:Pulmonary Artery; D012772:Shock, Septic / Q000601:surgery
Invasives Pulmonalis-Monitoring bei der akuten nekrotisierenden Pankreatitis. Eine Entscheidungshilfe für die Indikation zur Operation?