Fluid Resuscitation in Acute Pancreatitis
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Abstract
Acute pancreatitis is a common inflammatory disorder of the pancreas resulting in considerable morbidity and a mortality rate of approximately 5 %. Although there are no pharmacologic treatments known to improve important outcomes, aggressive intravenous fluid resuscitation is generally recommended in all patients. Recent human investigations have been performed in an attempt to answer several important questions that have not been answered, particularly in reference to the optimal resuscitative fluid, the role for colloid solutions, the ideal target clinical marker for fluid resuscitation, as well as the ideal time points for fluid administration. This review begins with a discussion related to the microcirculation of the pancreas and the pathophysiologic alterations caused by acute pancreatitis. Previous animal experiments will be described, as will the current status of recent and planned human studies specifically addressing fluid resuscitation. Finally, current recommendations and goals for further investigation will be highlighted. It is our hope that this review will stimulate interest in this previously overlooked subject and lead to further carefully designed prospective human clinical trials in the future.
Keywords
Acute Pancreatitis Fluid Resuscitation Severe Acute Pancreatitis Pancreatic Necrosis Necrotizing PancreatitisReferences
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