Hyperlipidaemia as a cause of acute pancreatitis: report of tow cases and review of the literature

Hyperlipidaemia is known to cause acute pancreatitis. Recently, we have encountered two such cases in one month. In this report, we present the two cases with review of relevant literature

Is regional tonometry a reliable index of tissue oxygenation? a comarative study with conventional global monitoring

This study was carried out on 30 critically ill patients admitted to the ICU of Farwania Hospital [Kuwait]. All patients had clinical evidence of organ dysfunction or impending multiple organ failure. The severity of their pathology on admission was assessed according to the APACHE II score. The study of each patient began after inserting the pulmonary artery catheter. The prospectively defined end-point of the study was the removal of the pulmonary artery catheter [72 hours] or death of the patient with the catheter in situ. The aim of the study was to determine the sensitivity and specificity of the intra-gastric mucosal pH [pHi] and other derived data in assessing the adequacy of tissue oxygenation, guiding therapy and prediction outcome. The results showed that pHi, pHa - pHi and PaCO2 - PO2 regional [reg] gradients were the most sensitive indices of tissue oxygenation and predictors of outcome. The mortality rate increased when pHi, PaCO2 - PCO2reg and pHa-pHi gradients were <7.3, > 10 mm Hg and <0.2 respectively. The derived variables obtained by invasive monitoring like base deficit [BD], lactate concentration in mixed venous blood [Lmv] and oxygn uptake index [02 UI] were valuable adjunct indices of tissue oxygenation. The risk of mortality increased when the BD was > - 5.5 +/- 1.2 meq.L -1, Lmv was> 4.5 +/- 1.2 mmol.L -1, and 02U1 was <100 +/- 6 ml.min -1 m -2. We recommend the use of gastric tonometry in routine ICU clinical practice