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Indian Journal of Gastroenterology
Erschienen in: Indian Journal of Gastroenterology 2/2020

13.04.2020 | Review Article

Acute respiratory distress syndrome in acute pancreatitis

verfasst von: Jimil Shah, Surinder S. Rana

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 2/2020

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Abstract

Development of organ failure is one of the major determinants of mortality in patients with acute pancreatitis (AP). Acute respiratory distress syndrome (ARDS) is an important cause of respiratory failure in AP and is associated with high mortality. Pathogenesis of ARDS in AP is incompletely understood. Release of various cytokines plays an important role in development of ARDS in AP. Increased gut permeability due to various toxins, inflammatory mediators, and pancreatic enzymes potentiates lung injury by gut-lymph-lung axis leading on to increased translocation of bacterial endotoxins. Various scoring systems, serum levels of various cytokines and lung ultrasound have been evaluated for prediction of development of ARDS in AP with varying results. Various drugs have shown encouraging results in prevention of ARDS in animal models but these encouraging results in animal models are yet to be confirmed in clinical studies. There is no specific effective treatment for ARDS. Treatment of sepsis and local complications of AP should be done according to the standard management strategies. Lung protective ventilatory strategies are of paramount importance to improve outcome of patients of AP with ARDS and therefore effective coordination between gastroenterologists and intensivists is needed for effective management of these patients.
Literatur
1.
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.
2.
Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut. 2019;68:1044–51.PubMedCrossRef
3.
Krishna SG, Kamboj AK, Hart PA, Hinton A, Conwell DL. The changing epidemiology of acute pancreatitis hospitalizations: a decade of trends and the impact of chronic pancreatitis. Pancreas. 2017;46:482–8.
4.
Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33:323–30.PubMedCrossRef
5.
Rana SS. An overview of walled-off pancreatic necrosis for clinicians. Expert Rev Gastroenterol Hepatol. 2019;13:331-43.
6.
Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med. 2017;377:562–72.PubMedCrossRef
7.
ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307:2526–33.
8.
Villar J, Sulemanji D, Kacmarek RM. The acute respiratory distress syndrome: incidence and mortality, has it changed? Curr Opin Crit Care. 2014;20:3–9.PubMedCrossRef
9.
Villar J, Blanco J, Kacmarek RM. Current incidence and outcome of the acute respiratory distress syndrome. Curr Opin Crit Care. 2016;22:1–6.PubMedCrossRef
10.
Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638–52.
11.
12.
Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53:1340–4.PubMedPubMedCentralCrossRef
13.
Karakattu S, Devani K, Reddy C, Hoskere G. Predictors and outcomes of acute respiratory failure amongst the patients hospitalized with acute pancreatitis. Chest. 2017;152:A217.CrossRef
14.
Lankisch PG, Rahlf G, Koop H. Pulmonary complications in fatal acute hemorrhagic pancreatitis. Dig Dis Sci. 1983;28:110–6.PubMed
15.
16.
Berry AR, Taylor TV, Davies GC. Pulmonary function and fibrinogen metabolism in acute pancreatitis. Br J Surg. 1981;68:870–3.PubMedCrossRef
17.
Büchler M, Malfertheiner P, Schädlich H, Nevalainen TJ, Friess H, Beger HG. Role of phospholipase A2 in human acute pancreatitis. Gastroenterology. 1989;97:1521–6.
18.
Kortesuo PT, Nevalainen TJ, Büchler M, Uhl W. Characterization of two phospholipases A2 in serum of patients with sepsis and acute pancreatitis. Eur J Clin Chem Clin Biochem. 1992;30:263–9.PubMed
19.
Uhl W, Schrag HJ, Schmitter N, Aufenanger J, Nevalainen TJ, Büchler MW. Experimental study of a novel phospholipase A2 inhibitor in acute pancreatitis. Br J Surg. 1998;85:618–23.
20.
21.
Kingsnorth AN, Galloway SW, Formela LJ. Randomized, double-blind phase II trial of Lexipafant, a platelet-activating factor antagonist, in human acute pancreatitis. Br J Surg. 1995;82:1414–20.PubMedCrossRef
22.
Johnson CD, Kingsnorth AN, Imrie CW, et al. Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis. Gut. 2001;48:62–9.
23.
Norman JG, Fink GW, Denham W, et al. Tissue-specific cytokine production during experimental acute pancreatitis. A probable mechanism for distant organ dysfunction. Dig Dis Sci. 1997;42:1783–8.PubMedCrossRef
24.
Malka D, Vasseur S, Bödeker H, et al. Tumor necrosis factor alpha triggers antiapoptotic mechanisms in rat pancreatic cells through pancreatitis-associated protein I activation. Gastroenterology. 2000;119:816–28.
25.
Donnelly SC, Strieter RM, Kunkel SL, et al. Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups. Lancet. 1993;341:643–7.
26.
Miller EJ, Cohen AB, Nagao S, et al. Elevated levels of NAP-1/interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality. Am Rev Respir Dis. 1992;146:427–32.
27.
Kurdowska A, Noble JM, Grant IS, Robertson CR, Haslett C, Donnelly SC. Anti-interleukin-8 autoantibodies in patients at risk for acute respiratory distress syndrome. Crit Care Med. 2002;30:2335–7.
28.
Mayer J, Rau B, Gansauge F, Beger HG. Inflammatory mediators in human acute pancreatitis: clinical and pathophysiological implications. Gut. 2000;47:546–52.PubMedPubMedCentralCrossRef
29.
30.
Sakai Y, Masamune A, Satoh A, Nishihira J, Yamagiwa T, Shimosegawa T. Macrophage migration inhibitory factor is a critical mediator of severe acute pancreatitis. Gastroenterology. 2003;124:725–36.
31.
Kasama T, Strieter RM, Lukacs NW, Burdick MD, Kunkel SL. Regulation of neutrophil-derived chemokine expression by IL-10. J Immunol. 1994;152:3559–69.
32.
Van Laethem J-L, Eskinazi R, Louis H, Rickaert F, Robberecht P, Devière J. Multisystemic production of interleukin 10 limits the severity of acute pancreatitis in mice. Gut. 1998;43:408–13.
33.
Rongione AJ, Kusske AM, Kwan K, Ashley SW, Reber HA, McFadden DW. Interleukin 10 reduces the severity of acute pancreatitis in rats. Gastroenterology. 1997;112:960–7.
34.
Wang X, Sun Z, Börjesson A, Andersson R. Inhibition of platelet-activating factor, intercellular adhesion molecule 1 and platelet endothelial cell adhesion molecule 1 reduces experimental pancreatitis-associated gut endothelial barrier dysfunction. Br J Surg. 1999;86:411–6.PubMedCrossRef
35.
Sun J, Bhatia M. Blockade of neurokinin-1 receptor attenuates CC and CXC chemokine production in experimental acute pancreatitis and associated lung injury. Am J Physiol Gastrointest Liver Physiol. 2007;292:G143–53.PubMedCrossRef
36.
Flint RS, Windsor JA. The role of the intestine in the pathophysiology and management of severe acute pancreatitis. HPB (Oxford). 2003;5:69–85.
37.
Montravers P, Chollet-Martin S, Marmuse JP, Gougerot-Pocidalo MA, Desmonts JM. Lymphatic release of cytokines during acute lung injury complicating severe pancreatitis. Am J Respir Crit Care Med. 1995;152:1527–33.
38.
Peng H, Zhi-Fen W, Su-Mei J, Yun-Zhen G, Yan L, Li-Ping C. Blocking abdominal lymphatic flow attenuates acute hemorrhagic necrotizing pancreatitis -associated lung injury in rats. J Inflamm (Lond). 2013;10:9. 
39.
Gray KD, Simovic MO, Chapman WC, et al. Endotoxin potentiates lung injury in cerulein-induced pancreatitis. Am J Surg. 2003;186:526–30.
40.
Sharif R, Dawra R, Wasiluk K, et al. Impact of toll-like receptor 4 on the severity of acute pancreatitis and pancreatitis-associated lung injury in mice. Gut. 2009;58:813–9.
41.
Liu H, Li Y, Wang L, Chen H, Guan J, Zhou Z Aggravation of acute pancreatitis by heparan sulfate in mice. Scand J Gastroenterol. 2009;44:626–32.
42.
43.
Gajic O, Dabbagh O, Park PK, et al. Early identification of patients at risk of acute lung injury: evaluation of lung injury prediction score in a multicenter cohort study. Am J Respir Crit Care Med. 2011;183:462–70.
44.
Trillo-Alvarez C, Cartin-Ceba R, Kor DJ, et al. Acute lung injury prediction score: derivation and validation in a population-based sample. Eur Respir J. 2011;37:604–9.
45.
Soto GJ, Kor DJ, Park PK, et al. Lung injury prediction score in hospitalized patients at risk of acute respiratory distress syndrome. Crit Care Med. 2016;44:2182–91.
46.
Agrawal A, Matthay MA, Kangelaris KN, et al. Plasma Angiopoietin-2 predicts the onset of acute lung injury in critically ill patients. Am J Respir Crit Care Med. 2013;187:736–42.PubMedPubMedCentralCrossRef
47.
Xu Z, Wu GM, Li Q, et al. Predictive value of combined LIPS and ANG-2 level in critically ill patients with ARDS risk factors. Mediat Inflamm. 2018;2018:1739615.
48.
Levitt JE, Bedi H, Calfee CS, Gould MK, Matthay MA. Identification of early acute lung injury at initial evaluation in an acute care setting prior to the onset of respiratory failure. Chest. 2009;135:936–43.
49.
Zhou Y, Fan Q, Cavus O, Zhang X. Lung ultrasound: predictor of acute respiratory distress syndrome in intensive care unit patients. Saudi J Anaesth. 2018;12:457–61.PubMedPubMedCentralCrossRef
50.
Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117–25.PubMedPubMedCentralCrossRef
51.
52.
Samanta J, Singh S, Arora S, et al. Cytokine profile in prediction of acute lung injury in patients with acute pancreatitis. Pancreatology. 2018;18:878–84.
53.
Skouras C, Davis ZA, Sharkey J, et al. Lung ultrasonography as a direct measure of evolving respiratory dysfunction and disease severity in patients with acute pancreatitis. HPB (Oxford). 2016;18:159–69.
54.
Katageri B, Rana SS, Bhatia A, et al. 448 - serial lung ultrasound in the assessment of volume status and disease severity in acute pancreatitis. Gastroenterology. 2018;154:S–103.
55.
Fei Y, Gao K, Li W-Q. Artificial neural network algorithm model as powerful tool to predict acute lung injury following to severe acute pancreatitis. Pancreatology. 2018;18:892–9.PubMedCrossRef
56.
57.
Lu X-G, Kang X, Zhan L-B, Kang LM, Fan ZW, Bai LZ. Circulating miRNAs as biomarkers for severe acute pancreatitis associated with acute lung injury. World J Gastroenterol. 2017;23:7440–9.
58.
Amiti, Tamizhselvi R, Manickam V. Menadione (vitamin K3) inhibits hydrogen sulfide and substance P via NF-кB pathway in caerulein-induced acute pancreatitis and associated lung injury in mice. Pancreatology. 2019;19:266–73.PubMedCrossRef
59.
Leema G, Tamizhselvi R. Protective effect of scopoletin against cerulein-induced acute pancreatitis and associated lung injury in mice. Pancreas. 2018;47:577–85.PubMedCrossRef
60.
Cui H, Li S, Xu C, Zhang J, Sun Z, Chen H. Emodin alleviates severe acute pancreatitis-associated acute lung injury by decreasing pre-B-cell colony-enhancing factor expression and promoting polymorphonuclear neutrophil apoptosis. Mol Med Rep. 2017;16:5121–8.
61.
Shi Z, Ye W, Zhang J, et al. LipoxinA4 attenuates acute pancreatitis-associated acute lung injury by regulating AQP-5 and MMP-9 expression, anti-apoptosis and PKC/SSeCKS-mediated F-actin activation. Mol Immunol. 2018;103:78–88.
62.
Yu J, Ni L, Zhang X, Zhang J, Abdel-Razek O, Wang G. Surfactant protein D dampens lung injury by suppressing NLRP3 inflammasome activation and NF-κB signaling in acute pancreatitis. Shock. 2019;51:557–68.
63.
Qiao Y-Y, Liu X-Q, Xu C-Q, Zhang Z, Xu HW. Interleukin-22 ameliorates acute severe pancreatitis-associated lung injury in mice. World J Gastroenterol. 2016;22:5023–32.
64.
Chen W, Janz DR, Bastarache JA, et al. Prehospital aspirin use is associated with reduced risk of acute respiratory distress syndrome in critically ill patients: a propensity-adjusted analysis. Crit Care Med. 2015;43:801–7.
65.
Erlich JM, Talmor DS, Cartin-Ceba R, Gajic O, Kor DJ. Prehospitalization antiplatelet therapy is associated with a reduced incidence of acute lung injury: a population-based cohort study. Chest. 2011;139:289–95.
66.
Kor DJ, Carter RE, Park PK, et al. Effect of aspirin on development of ARDS in at-risk patients presenting to the emergency department: the LIPS-A randomized clinical trial. JAMA. 2016;315:2406–14.
67.
Weigelt JA, Norcross JF, Borman KR, Snyder WH. Early steroid therapy for respiratory failure. Arch Surg. 1985;120:536–40.PubMedCrossRef
68.
Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA. Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest. 1987;92:1032–6.
69.
Luce JM, Montgomery AB, Marks JD, Turner J, Metz CA, Murray JF. Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis. 1988;138:62–8.
70.
71.
Falagas ME, Makris GC, Matthaiou DK, Rafailidis PI. Statins for infection and sepsis: a systematic review of the clinical evidence. J Antimicrob Chemother. 2008;61:774–85.PubMedCrossRef
72.
O'Neal HR Jr, Koyama T, Koehler EAS, et al. Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome. Crit Care Med. 2011;39:1343–50.
73.
Bajwa EK, Malhotra CK, Thompson BT, Christiani DC, Gong MN. Statin therapy as prevention against development of acute respiratory distress syndrome: an observational study. Crit Care Med. 2012;40:1470–7.
74.
Idell S, Kueppers F, Lippmann M, Rosen H, Niederman M, Fein A. Angiotensin converting enzyme in bronchoalveolar lavage in ARDS. Chest. 1987;91:52–6.
75.
76.
77.
Miller AC, Rivero A, Ziad S, Smith DJ, Elamin EM. Influence of nebulized unfractionated heparin and N-acetylcysteine in acute lung injury after smoke inhalation injury. J Burn Care Res. 2009;30:249–56.
78.
Zingg U, Hofer CK, Seifert B, Metzger U, Zollinger A. High dose N-acetylcysteine to prevent pulmonary complications in partial or total transthoracic esophagectomy: results of a prospective observational study. Dis Esophagus. 2007;20:399–405.PubMedCrossRef
79.
Gao Smith F, Perkins GD, Gates S, et al. Effect of intravenous β-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome (BALTI-2): a multicentre, randomised controlled trial. Lancet. 2012;379:229–35.
80.
Arvanitakis M, Dumonceau J-M, Albert J, et al. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy. 2018;50:524–46.PubMedCrossRef
81.
Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis. Gastroenterology. 2018;154:1096–101.PubMedCrossRef
82.
Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108:1400–15; 1416.
83.
Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome: advances in diagnosis and treatment. JAMA. 2018;319:698–710.PubMedCrossRef
84.
Papazian L, Forel J-M, Gacouin A, et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010;363:1107–16.
85.
National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Wiedemann HP, Wheeler AP, Bernard GR, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564–75.
86.
Needham DM, Colantuoni E, Mendez-Tellez PA, et al. Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study. BMJ. 2012;344:e2124.PubMedPubMedCentralCrossRef
87.
Needham DM, Yang T, Dinglas VD, et al. Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome. A prospective cohort study. Am J Respir Crit Care Med. 2015;191:177–85.PubMedPubMedCentralCrossRef
88.
Guérin C, Reignier J, Richard J-C, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368:2159–68.
89.
Fan E, Del Sorbo L, Goligher EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195:1253–63.PubMedCrossRef
90.
Briel M, Meade M, Mercat A, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA. 2010;303:865–73.
91.
Brower RG, Lanken PN, MacIntyre N, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med. 2004;351:327–36.PubMedCrossRef
92.
Fan E, Wilcox ME, Brower RG, et al. Recruitment maneuvers for acute lung injury: a systematic review. Am J Respir Crit Care Med. 2008;178:1156–63.PubMedCrossRef
93.
Huh JW, Jung H, Choi HS, Hong SB, Lim CM, Koh Y. Efficacy of positive end-expiratory pressure titration after the alveolar recruitment manoeuvre in patients with acute respiratory distress syndrome. Crit Care. 2009;13:R22.
94.
Young D, Lamb SE, Shah S, et al. High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med. 2013;368:806–13.PubMedCrossRef
95.
Ferguson ND, Cook DJ, Guyatt GH, et al. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med. 2013;368:795–805.
96.
Del Sorbo L, Cypel M, Fan E. Extracorporeal life support for adults with severe acute respiratory failure. Lancet Respir Med. 2014;2:154–64.PubMedCrossRef
97.
Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009;374:1351–63.
98.
National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Matthay MA, Brower RG, et al. Randomized, placebo-controlled clinical trial of an aerosolized β2-agonist for treatment of acute lung injury. Am J Respir Crit Care Med. 2011;184:561–8.
99.
Meduri GU, Headley AS, Golden E, et al. Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1998;280:159–65.
100.
Steinberg KP, Hudson LD, Goodman RB, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006;354:1671–84.
101.
Tang BMP, Craig JC, Eslick GD, Seppelt I, McLean AS. Use of corticosteroids in acute lung injury and acute respiratory distress syndrome: a systematic review and meta-analysis. Crit Care Med. 2009;37:1594–603.
102.
Lamontagne F, Briel M, Guyatt GH, Cook DJ, Bhatnagar N, Meade M. Corticosteroid therapy for acute lung injury, acute respiratory distress syndrome, and severe pneumonia: a meta-analysis of randomized controlled trials. J Crit Care. 2010;25:420–35.
103.
Cho Y-J, Moon JY, Shin E-S, et al. Clinical practice guideline of acute respiratory distress syndrome. Tuberc Respir Dis (Seoul). 2016;79:214–33.PubMedPubMedCentralCrossRef
104.
Adhikari NKJ, Dellinger RP, Lundin S, et al. Inhaled nitric oxide does not reduce mortality in patients with acute respiratory distress syndrome regardless of severity: systematic review and meta-analysis. Crit Care Med. 2014;42:404–12.PubMedCrossRef
105.
Fan E, Mehta S. High-frequency oscillatory ventilation and adjunctive therapies: inhaled nitric oxide and prone positioning. Crit Care Med. 2005;33:S182–7.PubMedCrossRef
106.
National Heart, Lung, and Blood Institute ARDS Clinical Trials Network, Truwit JD, Bernard GR, et al. Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med. 2014 ;370:2191–200.
107.
Agus A, Hulme C, Verghis RM, et al. Simvastatin for patients with acute respiratory distress syndrome: long-term outcomes and cost-effectiveness from a randomised controlled trial. Crit Care. 2017 ;21:108.
108.
Ware LB, Matthay MA. Keratinocyte and hepatocyte growth factors in the lung: roles in lung development, inflammation, and repair. Am J Phys Lung Cell Mol Phys. 2002;282:L924–40.
109.
Papazian L, Aubron C, Brochard L, et al. Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care. 2019;9:69.
Metadaten
Titel
Acute respiratory distress syndrome in acute pancreatitis
verfasst von
Jimil Shah
Surinder S. Rana
Publikationsdatum
13.04.2020
Verlag
Springer India
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 2/2020
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-020-01016-z

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