Pulmonary function and fibrinogen metabolism in acute pancreatitis.

Respiratory complications were studied in 50 patients with acute pancreatitis, and the relationship of these complications to parameters of fibrinogen metabolism was investigated. The mean arterial P02 of the patients was 9.85 +/- 3.8 kPa (s.d.). Forty-three per cent of patients on admission were hypoxaemic. The mean PO2 was lower in patients who subsequently developed complications of acute pancreatitis (mean P02 7.85 +/- 1.42 kPa (s.d.), P less than 0.01). Vital capacity on admission was decreased by 50 per cent in 41 per cent of patients and by 20 per cent decrease in their vital capacity. Fibrinogen levels were elevated in 80 per cent of of patients on admission and there was a negative correlation between these levels and the arterial P02 (r = -0.6, P less than 0.001). Fibrinogen degradation products were elevated in 45 per cent of patients. The results confirm that marked lung damage occurs in acute pancreatitis and suggest that the effects are prolonged. The possibility that this damage may be related to pulmonary fibrin deposition is discussed.