Abstract: To explore the clinical features and management of acute respiratory distress syndrome (ARDS) in patients with severe acute pancreatitis (SAP), clinical data of 246 patients with SAPwere reviewed retrospectively in our hospital between 1990 and 2001. The data of occurrence time, respiratory conditions, arterial blood-gas analysis and chest film from 68 patients with ARDS were analyzed. Meanwhile comparisons between patients with ARDS and patients without ARDS were made. The incidence rate of ARDS in patients with SAP was 27.6% . The main features of these patients included early occurrence (73.5% occurred during the first 3 days of SAP or 3 days after operation), increasing respiratory rate (36. 76±0.92/min), respiratory distress(39.7%), respiratory alkalosis and respiratory alkalosis complicated with metabolic acidosis(89.7%). The main factors predisposing to ARDS in patients with SAP were increased serum triglyceride level, higher APACHE-Ⅱscore, intra-abdominal hypertension and operation. Decreasing serum triglyceride level, relieving intra-abdominal hypertension, strictly controlling for operation and applying ventilator timely and properly may be helpful to the prevention and treatment of ARDS in patients with SAP.

Key words: pancreatitis, respiratory distress syndrome, therapy