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Three Part Question

Following the diagnosis of [acute pancreatitis in adults], is the practice of giving [early oxygen therapy] associated with [a lower mortality]?

Clinical Scenario

A 50 year old gentleman has just been admitted to the emergency department with a working diagnosis of severe acute pancreatitis. Fluid resuscitation was given to replace losses but you do not understand the rational behind giving oxygen and wonders if there are any evidences to support the reason behind oxygen supplementation.

Search Strategy

OVID MEDLINE 1946 to June Week 3 2012
EMBASE 1974 to 2012 July 03

[(exp Pancreatitis, Acute Necrotizing/ OR exp Pancreatitis/ OR exp Pancreatitis, Chronic/ OR exp Pancreatitis, Alcoholic/ OR pancreatitis.mp.) AND (oxygen therapy.mp. or exp Oxygen/ OR supplemental oxygen.mp.)] LIMIT to Human AND English Language.

Search Outcome

187 results were found but none were relevant.

Comment(s)

Supplementary oxygen are amongst the choices of initial interventions available for patients with a diagnosis of acute pancreatitis, regardless of severity. The practise of giving oxygen recommended by the current UK guidelines based on evidences suggesting benefits of early organ failure resolution and a low mortality. Moreover, it tackles the issue of hypoxia which are seen in many patients with pulmonary involvement as a result of circulating inflammatory mediators. Pulse oximetry is used to monitor arterial saturation and should be maintained at above 95%. Progressively worsening hypoxia despite oxygenation is an indication of severe acute pancreatitis and usually indicates a need for care in the intensive unit, or worse, the need for mechanical ventilation. Thus, the aim of this BET was to identify the said advantages of providing early oxygen supplementation

Clinical Bottom Line

No evidences were found to support the benefits of early oxygen supplementation.