Skip to main content

Acute Pancreatitis in Intensive Care

  • Chapter
  • First Online:
Pancreatic Disease

Abstract

Severe acute pancreatitis is associated with the development of the systemic inflammatory response syndrome (SIRS).

Hypoxemia is a hallmark of acute pancreatitis and respiratory failure is the most common single organ failure in this disease. In the most severely ill patients multi-organ dysfunction syndrome (MODS) and multi-organ failure (MOF) occur. Intensive care with multiple organ support is necessary.

In this review, we have considered the key issues relevant to acute pancreatitis in the intensive care unit (ICU). We have identified areas that may merit further research, specifically in patients with severe acute pancreatitis, who are receiving intensive care or have a high risk of developing multi-organ failure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Al-Omran M, Groof A, Wilke D (2006) Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev 4

    Google Scholar 

  • Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troche G, Chaumet-Riffaut P, Bellissant E (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862-871

    Article  PubMed  CAS  Google Scholar 

  • ARDSnet (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and acute respiratory distress syndrome. New Engl J Med 342:1301-1308

    Article  Google Scholar 

  • Eatock FC, Chong P, Menezes N et al (2005) A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis. Am J Gastroenterol 100(2):432-439

    Article  PubMed  CAS  Google Scholar 

  • Eggimann P, Jamdar S, Siriwardena AK (2006) Antifungal prophylaxis is important to prevent fungal infection in patients with acute necrotizing pancreatitis receiving broad-spectrum antibiotics. Crit Care 10(5):229

    Article  PubMed  Google Scholar 

  • Garcea G, Jackson B, Pattenden C, Sutton C, Neal C, Dennison AR, Berry D (2006) Early warning scores predict outcome in acute pancreatitis. J Gastr Surg 10(7):1008-1015

    Article  Google Scholar 

  • Jamdar S, Siriwardena A (2005) Drotrecogin alfa (recombinant human activated protein C) in severe acute pancreatitis. Crit Care 9(4):321-322

    Article  PubMed  Google Scholar 

  • Kalfarentzos F, Kehagias J, Mead N et al (1997) Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomized prospective trial. Br J Surg 84(12):1665-1669

    Article  PubMed  CAS  Google Scholar 

  • Liu N, Ying MY, Ying L (2006) Upper gastrointestinal and pancreatic diseases group lexipafant for acute pancreatitis. Cochrane Database Syst Rev 4

    Google Scholar 

  • Olah A, Pardavi G, Belagyi T et al (2002) Early nasojejunal feeding in acute pancreatitis is associated with a lower complication rate. Nutrition 18(3):259-262

    Article  PubMed  Google Scholar 

  • Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. New Engl J Med 345:1368-1377

    Article  PubMed  CAS  Google Scholar 

  • Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G (2000) Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 356(9223):26-30

    Article  PubMed  CAS  Google Scholar 

  • The National Heart, Lung and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network (2006) Comparison of two fluid-management strategies in acute lung injury. New Engl J Med 354:2564-2575

    Article  Google Scholar 

  • The SAFE study investigators (2004) A comparison of albumin and saline for fluid resuscitation in the intensive care unit. New Engl J Med 350:2247-2256

    Article  Google Scholar 

  • Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R (2001) Intensive insulin therapy in critically ill patients. New Engl J Med 345:1359-1367

    Article  PubMed  Google Scholar 

  • Villatoro E, Bassi C, Larvin M (2006) Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev 18;(4) CD002941

    Google Scholar 

  • Vinsonneau C, Camus C, Combes A, Costa de Beauregard MA, Klouche K, Boulain T, Pallot JL, Chiche JD, Taupin P, Landais P, Dhainaut JF (2006) on behalf of the Hemodiafe Study Group. Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple organ dysfunction syndrome: a multicentre randomised trial. Lancet 368:379-385

    Article  PubMed  Google Scholar 

  • Wang Hao, Li Wei-Qin, Zhou Wei, Li Ning, Li Jie-Shou (2003) Clinical effects of continuous high volume hemofiltration on severe acute pancreatitis complicated with multiple organ dysfunction syndrome. World J Gastroenterol 9(9):2096-2099

    PubMed  Google Scholar 

  • Windsor AC, Kanwar S, Li AG et al (1998) Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis. Gut 42(3):431-435

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John Kinsella .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag London Limited

About this chapter

Cite this chapter

Kinsella, J., Clements, B., Dickson, E., Dugernier, T., Hughes, M. (2010). Acute Pancreatitis in Intensive Care. In: Johnson, C., Imrie, C. (eds) Pancreatic Disease. Springer, London. https://doi.org/10.1007/978-1-84882-118-7_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-118-7_1

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-117-0

  • Online ISBN: 978-1-84882-118-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics