A 40-Year-Old Man Is Evaluated in the Hospital After Being

A 40-year-old man is evaluated in the hospital after being admitted for acute alcohol-induced pancreatitis 24 hours ago.  He has been receiving aggressive intravenous hydration and pain control.  Over the past 2 hours, the patient has become increasingly restless and now reports difficulty breathing and abdominal distension.  Blood pressure is 80/60 mm Hg, pulse is 122/min, and respirations are 28/min.  Heart and lung sounds are normal.  The abdomen is significantly distended and tense.  Bowel sounds are decreased.  Bilateral lower extremity and flank edema are present.  Chest x-ray reveals basilar atelectasis but no other infiltrates.  His urine output has markedly decreased over the past 2 hours.  Which of the following pathophysiologic changes are most likely present in this patient at this time compared to a few hours earlier?

A) Decreased cardiac preload
B) Decreased central venous pressure
C) Decreased lower extremity venous pressure
D) Increased abdominal wall compliance
E) Increased cardiac output

Correct Answer:

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