DOI: https://doi.org/10.22263/2312-4156.2025.1.53
K.V. Nikitina, G.V. Ilukevich
Differentiated approach to respiratory support in patients with acute pancreatitis
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2025;24(1):53-61.
Abstract.
Objectives. To develop a differentiated approach to respiratory support in patients with acute pancreatitis.
Material and methods. The dynamics of respiratory status indicators was analyzed in 106 patients with acute pancreatitis with different approaches to respiratory support. Depending on its type and need, patients were divided into 4 groups: Group 1 – 31 patients with early artificial lung ventilation (ALV), Group 2 – 26 patients with late ALV, Group 3 – 25 patients with oxygen therapy through nasal cannulas or face masks, Group 4 – 24 patients without respiratory support.
Results. Patients in severe condition with severe acute pancreatitis are characterized by significant changes in respiratory status: low pO2/FiO2 (300 mmHg and below), hypocapnia (pCO2 below 30 mmHg), hyperlactatemia over 2,0 mmol/l. Early initiation of mechanical ventilation, in the first 24-48 hours, promptly corrects these changes, reducing mortality in the early phase of the disease up to 19,4%. Delayed mechanical ventilation, despite strict parameters, is ineffective and is accompanied by a mortality rate in the early phase of the disease of 30,8%. Patients with severe acute pancreatitis, but with moderate severity of the condition, do not have significant changes in respiratory status, oxygen therapy through nasal cannulas or face masks is sufficient for them. Patients with a mild course of the disease do not have changes in respiratory status that require respiratory support.
Conclusions. Severe condition of patients with severe acute pancreatitis is accompanied by significant respiratory status disorders, which requires early mechanical ventilation in the first 24-48 hours. Moderate severity of the condition against the background of severe course of the disease is associated with minor changes in the respiratory status, corrected by oxygen therapy through nasal cannulas or face masks. Mild acute pancreatitis is not accompanied by respiratory disorders requiring respiratory support.
Keywords: acute pancreatitis, severity of acute pancreatitis, respiratory index, oxygen partial pressure, carbon dioxide partial pressure, lactate, saturation.
Acknowledgments. The authors express their sincere gratitude journal editorial board for the opportunity to publish the article, as well as anonymous reviewers
Information about sources of funding in the form of grants, equipment, and medicines. The work was carried out in accordance with the scientific research plan of Vitebsk State Order of Peoples’ Friendship Medical University within the framework of the theme of State Scientific Research Programs 3.61 “To develop a method of organ protective intensive therapy of pancreatitis-associated multiple organ dysfunction”. The author did not receive financial support from drug manufacturers.
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Submitted 17.07.2024
Accepted 11.02.2025
Information about authors:
K.V. Nikitsina – Candidate of Medical Sciences, associate professor, head of the Chair of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0003-4744-6838,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Katsyaryna V. Nikitsina;
G.V. Ilukevich – Doctor of Medical Sciences, professor, https://orcid.org/0000-0002-3474-621X.
