Myocardial Function in Acute Pancreatitis

Abstract

Fifteen patients with acute pancreatitis had 68 physiologic cardiopulmonary assessments performed. They were compared with 61 performed on normal postoperative patients and 113 on 41 cirrhotics. The patients with pancreatitis have an elevated cardiac index (CI), which is not due to the hyperdynamic hemodynamic state found in cirrhotics. The Sarnoff curves demonstrated that pancreatitis was accompanied by a myocardial depression (P < 0.03) not found in hyperdynamic cirrhotics. Cirrhotics are unable to increase their O2 consumption in response to an increase in CI, as do normal patients or those with acute pancreatitis. In cirrhotics, the hemodynamic lesion occurs at the capillary level with the opening of arteriovenous shunts which rob the tissues of their nutritive blood supply; the patient with acute pancreatitis has a primary myocardial depression and his peripheral vasculature reacts like that of a normal person.