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Exocrine pancreatic dysfunction in sepsis.

B Tribl1, W J Sibbald, H Vogelsang

  • 1Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, University of Vienna, Vienna, Austria. barbara.tribl@akh-wien.ac.at

European Journal of Clinical Investigation
|March 19, 2003
PubMed
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Sepsis causes pancreatic exocrine dysfunction, which worsens with septic shock. This impairment in digestive enzyme secretion correlates with disease severity scores like APACHE III and SOFA.

Area of Science:

  • Critical care medicine
  • Gastroenterology
  • Pancreatic physiology

Background:

  • Sepsis in critically ill patients often leads to multiple organ failure.
  • The relationship between sepsis severity and exocrine pancreatic dysfunction requires further investigation.

Purpose of the Study:

  • To determine the correlation between sepsis severity and exocrine pancreatic dysfunction.
  • To compare pancreatic exocrine function in patients with and without septic shock.

Main Methods:

  • Prospective cohort study involving 21 critically ill, mechanically ventilated sepsis patients and 7 healthy controls.
  • Exocrine pancreatic function assessed using secretin-cholecystokinin tests.
  • Comparison of duodenal fluid enzyme and bicarbonate content between sepsis patients and controls.

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Main Results:

  • Sepsis patients without shock showed reduced amylase and chymotrypsin levels.
  • Septic shock patients exhibited impaired secretion of amylase, chymotrypsin, trypsin, and bicarbonate.
  • Amylase secretion significantly correlated with APACHE III and SOFA scores; trypsin secretion correlated with SOFA score.

Conclusions:

  • Sepsis is linked to secretory pancreatic dysfunction, more pronounced in septic shock.
  • Impaired exocrine pancreatic function severity is significantly correlated with APACHE III and SOFA scores.