TO STUDY ARTERIAL BLOOD GAS ANALYSIS IN PATIENTS OF ACUTE PANCREATITIS PRESENTING TO TERTIARY CARE CENTRE.

Abstract

Background: Acute pancreatitis is an inflammatory process of the pancreas, with variable involvement of peripancreatic tissues and remote organ systems. In 80% of the cases the disease is mild, with interstitial oedema, and leads to recovery within days or weeks. The development of metabolic acidosis (MA) is a common occurrence during critical illness. Arterial base deficit/excess (BD/E) is a commonly used marker of MA in critically ill patients. MA has been one of the criteria used for predicting a severe course of AP.

Methods: Patients with acute pancreatitis presenting to Gastroenterology section of Medicine Department between November 2015 and October 2016 were prospectively studied. ABG analysis was done at admission and development of organ failure, any need for intervention, and mortality were noted. The association between various parameters of ABG analysis and the development of organ failure or local complications, need for interventions (endoscopic/radiological/surgical) and mortality were analysed.

Results: In the present study of 55 patients, ABG parameters were used and correlated with organ failure and mortality in patients of acute pancreatitis. In current study respiratory failure was present in 66.66% patients with p02 <75 mm hg compared to 4.76% with p02 >75 mm hg. All 4 deaths in study were in the group with p02 <75 mm Hg. Thirty eight patients in our study had base deficit of

 >-4, whereas 13 had base deficit of <-4 mEq/L. Organ failure was present in 15 of the patients (39.47%) with base deficit >-4 mEq/L. In current study, patients with evidence of pH <7.35 had higher frequency of Organ failure (pulmonary failure, shock and renal failure).

Conclusion: In our study, 55 patients of Acute Pancreatitis were enrolled and ABG was done from the day of admission for consecutive 5 days. Parameters included were p02, pC02, bicarbonate, base deficit and oxygen saturation. There was a male predominance with 81.18% of the patients being male. This could be because of higher consumption of alcohol in males as compared to females.66.66% patients had oxygen saturation < 75 mm Hg.29.09% patients experienced Organ failure and 27.27%  had Respiratory failure, 7.27% had Renal failure, 3.63% developed Shock and 7.27% patients died.

Keywords: Acute pancreatitis; Base deficit; metabolic acidosis; Organ failure