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Current controversies in fluid resuscitation in acute pancreatitis: a systematic review.
MedLine Citation:
PMID:  22781906     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas resulting in considerable morbidity and mortality. Aggressive intravenous fluid resuscitation generally is recommended in all patients with AP and remains the cornerstone of management of these patients. However, the optimal rate, type, and the goal of resuscitation remain unclear. The purpose of this review was to give an insight about the pathophysiologic alterations in the pancreatic microcirculation that occur in AP, the markers for early recognition of severity of pancreatitis, the optimal fluid, and timing and extent of fluid resuscitation. An early elevated hematocrit, blood urea nitrogen, or creatinine should prompt clinicians to institute more intensive early resuscitation measures. Crystalloids are the currently recommended fluids for management of these patients. Current studies are underway to determine the optimal end points of fluid resuscitation that determine outcome. ABBREVIATIONS: AP - acute pancreatitisBUN - blood urea nitrogenCVP - central venous pressureSAP - severe acute pancreatitisSIRS - severe inflammatory response syndrome.
Authors:
Guru Trikudanathan; Udayakumar Navaneethan; Santhi Swaroop Vege
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreas     Volume:  41     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  827-34     Citation Subset:  IM    
Affiliation:
From the *Department of Internal Medicine, University of Connecticut Medical Center, Farmington, CT; †Digestive Disease Institute, The Cleveland Clinic, Cleveland, OH; and ‡Division of Gastroenterology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
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