From acute pancreatitis to end-organ injury: mechanisms of acute lung injury.
BACKGROUND
Multi-organ dysfunction, and in particular lung injury, is often responsible for the unfavorable outcome of patients with severe acute pancreatitis. Understanding of the mechanisms by which local inflammation in the pancreas leads to end-organ injury is crucial for the development of new therapeutic strategies.


METHODS
A MEDLINE search was performed with the terms "acute pancreatitis," "lung injury," "inflammatory response," "SIRS," and "multi-organ dysfunction." Pertinent articles were selected for analysis.


RESULTS
Modulation of the inflammatory response using a combination of immunomodulatory agents may decrease the incidence of severe pancreatitis-related acute lung injury and acute respiratory distress syndrome.


CONCLUSIONS
Clinical trials are of utmost importance to establish the validity of such strategies.
De Campos
Tercio
T
Division of Trauma, University of California-San Diego, 200 W. Arbor Drive, San Diego, CA 92103, USA.
Deree
Jessica
J
Coimbra
Raul
R
D000208:Acute Disease; D016207:Cytokines / Q000502:physiology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000502:physiology / Q000592:standards; D008833:Microcirculation; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000517:prevention & control; D010179:Pancreas / Q000098:blood supply / Q000503:physiopathology; D010195:Pancreatitis / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*
D016207:Cytokines; D007155:Immunologic Factors; D018836:Inflammation Mediators