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World J Gastrointest Oncol. 2016 Jul 15;8(7):526-31. doi: 10.4251/wjgo.v8.i7.526.

Pancreatic injury in patients with septic shock: A literature review.

World journal of gastrointestinal oncology

Anis Chaari, Karim Abdel Hakim, Kamel Bousselmi, Mahmoud Etman, Mohamed El Bahr, Ahmed El Saka, Eman Hamza, Mohamed Ismail, Elsayed Mahmoud Khalil, Vipin Kauts, William Francis Casey

Affiliations

  1. Anis Chaari, Karim Abdel Hakim, Kamel Bousselmi, Mahmoud Etman, Mohamed El Bahr, Ahmed El Saka, Eman Hamza, Mohamed Ismail, Elsayed Mahmoud Khalil, Vipin Kauts, William Francis Casey, Department of Intensive Care, King Hamed University Hospital, Al Muharaq 24343, Bahrain.

PMID: 27559431 PMCID: PMC4942740 DOI: 10.4251/wjgo.v8.i7.526

Abstract

Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully investigated. In fact, pancreatic injury may occur because of ischemia, overwhelming inflammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock. However, imaging test rarely reveal significant pancreatic damage. Whether pancreatic dysfunction does affect the prognosis of patients with septic shock or not is still a matter of debate. In fact, only few studies with limited sample size assessed the clinical relevance of the pancreatic injury in this group of patients. In this review, we aimed to describe the epidemiology and the physiopathology of pancreatic injury in septic shock patients, to clarify whether it requires specific management and to assess its prognostic value. Our main finding is that pancreatic injury does not significantly affect the outcome in septic shock patients. Hence, increased serum pancreatic enzymes without clinical features of acute pancreatitis do not require further imaging investigations and specific therapeutic intervention.

Keywords: Amylase; Lipase; Pancreas; Prognosis; Septic shock

References

  1. Curr Opin Crit Care. 2013 Apr;19(2):128-32 - PubMed
  2. Crit Care Med. 1993 Feb;21(2 Suppl):S44-9 - PubMed
  3. Free Radic Res. 2006 Jul;40(7):665-72 - PubMed
  4. Crit Care Med. 2008 Jan;36(1):296-327 - PubMed
  5. Pathol Res Pract. 1989 May;184(5):507-13 - PubMed
  6. Crit Rev Immunol. 2015;35(4):277-91 - PubMed
  7. Ann Surg. 1989 Mar;209(3):279-83 - PubMed
  8. Chest. 2005 Jan;127(1):246-50 - PubMed
  9. Intensive Care Med. 1997 Mar;23(3):282-7 - PubMed
  10. Crit Care. 2014 Oct 03;18(5):532 - PubMed
  11. Intensive Care Med. 2007 Jan;33(1):25-35 - PubMed
  12. Pancreas. 1998 Aug;17(2):120-6 - PubMed
  13. Chest. 1991 Dec;100(6):1703-11 - PubMed
  14. Crit Care Med. 1985 Jul;13(7):532-3 - PubMed
  15. Intensive Care Med. 2007 Sep;33(9):1633-6 - PubMed
  16. BMC Vet Res. 2013 Jun 07;9:112 - PubMed
  17. J Thromb Haemost. 2004 Nov;2(11):1924-33 - PubMed
  18. Intensive Care Med. 2013 Feb;39(2):165-228 - PubMed
  19. Crit Care. 2015 Sep 15;19:324 - PubMed
  20. Eur J Clin Invest. 2003 Mar;33(3):239-43 - PubMed
  21. Crit Care Med. 1995 Jun;23(6):1040-7 - PubMed
  22. World J Gastroenterol. 2006 Feb 7;12(5):780-3 - PubMed
  23. World J Crit Care Med. 2012 Jun 04;1(3):67-79 - PubMed
  24. Crit Care Med. 1999 Jul;27(7):1230-51 - PubMed
  25. Eur J Pharmacol. 1994 Aug 22;261(3):265-72 - PubMed
  26. Crit Care Med. 2000 Sep;28(9):3233-41 - PubMed
  27. Ups J Med Sci. 2012 Aug;117(3):257-63 - PubMed
  28. Dig Surg. 2000;17(1):3-14 - PubMed
  29. J Crit Care. 2014 Apr;29(2):249-52 - PubMed
  30. Br J Pharmacol. 1996 May;118(2):261-70 - PubMed
  31. Shock. 1998 Jul;10(1):13-9 - PubMed
  32. Am J Physiol Heart Circ Physiol. 2004 Jan;286(1):H340-5 - PubMed
  33. Cell Stress Chaperones. 2010 Nov;15(6):965-75 - PubMed
  34. Crit Care Med. 2001 Jul;29(7):1303-10 - PubMed
  35. Shock. 1999 Jan;11(1):44-50 - PubMed
  36. N Engl J Med. 1994 Apr 28;330(17):1198-210 - PubMed
  37. Crit Care Med. 2008 Aug;36(8):2328-34 - PubMed
  38. J Surg Res. 1987 Sep;43(3):226-33 - PubMed
  39. Am J Respir Crit Care Med. 2003 Jul 15;168(2):165-72 - PubMed
  40. N Engl J Med. 2001 Nov 8;345(19):1368-77 - PubMed
  41. Crit Care Med. 2010 Feb;38(2 Suppl):S26-34 - PubMed
  42. Intensive Care Med. 2011 Aug;37(8):1302-10 - PubMed
  43. Curr Opin Anaesthesiol. 2015 Apr;28(2):227-36 - PubMed
  44. N Engl J Med. 2013 Nov 21;369(21):2063 - PubMed
  45. Indian J Crit Care Med. 2013 Jan;17(1):49-52 - PubMed
  46. ANZ J Surg. 2001 Oct;71(10):577-82 - PubMed
  47. N Engl J Med. 2003 Apr 17;348(16):1546-54 - PubMed
  48. Ann Intensive Care. 2015 Dec;5(1):51 - PubMed
  49. Clin J Am Soc Nephrol. 2007 May;2(3):431-9 - PubMed
  50. J Biochem. 2013 Jan;153(1):93-101 - PubMed
  51. World J Gastroenterol. 2002 Jun;8(3):406-12 - PubMed
  52. Intensive Care Med. 2007 Jan;33(1):13-24 - PubMed
  53. Bibl Haematol. 1983;(49):95-106 - PubMed
  54. Gut. 1996 May;38(5):747-52 - PubMed
  55. J Crit Care. 2012 Aug;27(4):384-93 - PubMed
  56. Crit Care. 2013 Aug 07;17(4):R171 - PubMed
  57. J Am Diet Assoc. 1998 Sep;98(9):1001-8 - PubMed
  58. Crit Care Med. 2000 May;28(5):1393-8 - PubMed
  59. Blood. 2000 Jul 1;96(1):170-5 - PubMed
  60. Hepatobiliary Pancreat Dis Int. 2011 Apr;10(2):191-5 - PubMed
  61. Biomed Res Int. 2015;2015:789298 - PubMed
  62. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15 - PubMed
  63. J Gastroenterol Hepatol. 2011 Mar;26 Suppl 2:12-6 - PubMed
  64. Semin Thromb Hemost. 2010 Jun;36(4):367-77 - PubMed

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