Do elevated serum pancreatic enzyme levels after hemorrhagic shock predict organ failure and death?
: Serum levels of pancreatic enzymes are elevated in patients who present in shock or require a massive transfusion and are independent predictors of organ failure. Whether these elevations are caused by ischemic pancreatitis or the translocation of intraluminal enteric pancreatic enzymes is uncertain and future studies are needed. Trauma patients with elevated pancreatic enzymes in the absence of a pancreatic injury have an increased risk of morbidity and mortality.
Treatment of ruptured aneurysms within 24 hours is associated with improved clinical outcomes compared with treatment at>24 hours. The benefit is more pronounced for coiling than clipping.