Fluid Management in Acute Pancreatitis

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Fluid Management in Acute Pancreatitis
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Jorge D. Machicado, MD, MPH

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References

  1. Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis [published correction appears in Am J Gastroenterol. 2014;109(2):302]. Am J Gastroenterol. 2013;108(9):1400-1415. doi:10.1038/ajg.2013.218 

  1. de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022;387(11):989-1000. doi:10.1056/NEJMoa2202884 

  1. Zhao G, Zhang JG, Wu HS, et al. Effects of different resuscitation fluid on severe acute pancreatitis. World J Gastroenterol. 2013;19(13):2044-2052. doi:10.3748/wjg.v19.i13.2044 

  1. Guzmán-Calderón E, Diaz-Arocutipa C, Monge E. Lactate Ringer's versus normal saline in the management of acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Dig Dis Sci. 2022;67(8):4131-4139. doi:10.1007/s10620-021-07269-8 

  1. Hoste EA, Maitland K, Brudney CS, et al; ADQI XII Investigators Group. Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth. 2014;113(5):740-747. doi:10.1093/bja/aeu300 

  1. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 suppl 2):e1-e15. doi:10.1016/j.pan.2013.07.063 

  1. Machicado JD, Papachristou GI. Pharmacologic management and prevention of acute pancreatitis. Curr Opin Gastroenterol. 2019;35(5):460-467. doi:10.1097/MOG.0000000000000563 

Author and Disclosure Information

Jorge D. Machicado, MD, MPH

Clinical Assistant Professor
Division of Gastroenterology and Hepatology
University of Michigan
Ann Arbor, Michigan

Disclosures:
Serve(d) as a speaker for: Mauna Kea Technologies (Paris, France 10/21)
Received income in an amount equal to or greater than $250 from: Mauna Kea Technologies (Paris, France 10/21)

Publications
GI and Hepatology News
Topics
Endoscopy, Pancreas, & Biliary Tract
Pancreas and Biliary Tract
Author(s)
Jorge D. Machicado, MD, MPH
Author(s)
Jorge D. Machicado, MD, MPH
Author and Disclosure Information

Jorge D. Machicado, MD, MPH

Clinical Assistant Professor
Division of Gastroenterology and Hepatology
University of Michigan
Ann Arbor, Michigan

Disclosures:
Serve(d) as a speaker for: Mauna Kea Technologies (Paris, France 10/21)
Received income in an amount equal to or greater than $250 from: Mauna Kea Technologies (Paris, France 10/21)

Author and Disclosure Information

Jorge D. Machicado, MD, MPH

Clinical Assistant Professor
Division of Gastroenterology and Hepatology
University of Michigan
Ann Arbor, Michigan

Disclosures:
Serve(d) as a speaker for: Mauna Kea Technologies (Paris, France 10/21)
Received income in an amount equal to or greater than $250 from: Mauna Kea Technologies (Paris, France 10/21)

Click here to view more from Gastroenterology Data Trends 2024

Click here to view more from Gastroenterology Data Trends 2024

References

  1. Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis [published correction appears in Am J Gastroenterol. 2014;109(2):302]. Am J Gastroenterol. 2013;108(9):1400-1415. doi:10.1038/ajg.2013.218 

  1. de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022;387(11):989-1000. doi:10.1056/NEJMoa2202884 

  1. Zhao G, Zhang JG, Wu HS, et al. Effects of different resuscitation fluid on severe acute pancreatitis. World J Gastroenterol. 2013;19(13):2044-2052. doi:10.3748/wjg.v19.i13.2044 

  1. Guzmán-Calderón E, Diaz-Arocutipa C, Monge E. Lactate Ringer's versus normal saline in the management of acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Dig Dis Sci. 2022;67(8):4131-4139. doi:10.1007/s10620-021-07269-8 

  1. Hoste EA, Maitland K, Brudney CS, et al; ADQI XII Investigators Group. Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth. 2014;113(5):740-747. doi:10.1093/bja/aeu300 

  1. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 suppl 2):e1-e15. doi:10.1016/j.pan.2013.07.063 

  1. Machicado JD, Papachristou GI. Pharmacologic management and prevention of acute pancreatitis. Curr Opin Gastroenterol. 2019;35(5):460-467. doi:10.1097/MOG.0000000000000563 

References

  1. Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis [published correction appears in Am J Gastroenterol. 2014;109(2):302]. Am J Gastroenterol. 2013;108(9):1400-1415. doi:10.1038/ajg.2013.218 

  1. de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022;387(11):989-1000. doi:10.1056/NEJMoa2202884 

  1. Zhao G, Zhang JG, Wu HS, et al. Effects of different resuscitation fluid on severe acute pancreatitis. World J Gastroenterol. 2013;19(13):2044-2052. doi:10.3748/wjg.v19.i13.2044 

  1. Guzmán-Calderón E, Diaz-Arocutipa C, Monge E. Lactate Ringer's versus normal saline in the management of acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Dig Dis Sci. 2022;67(8):4131-4139. doi:10.1007/s10620-021-07269-8 

  1. Hoste EA, Maitland K, Brudney CS, et al; ADQI XII Investigators Group. Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth. 2014;113(5):740-747. doi:10.1093/bja/aeu300 

  1. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 suppl 2):e1-e15. doi:10.1016/j.pan.2013.07.063 

  1. Machicado JD, Papachristou GI. Pharmacologic management and prevention of acute pancreatitis. Curr Opin Gastroenterol. 2019;35(5):460-467. doi:10.1097/MOG.0000000000000563 

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GI and Hepatology News
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Endoscopy, Pancreas, & Biliary Tract
Pancreas and Biliary Tract
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Fluid Management in Acute Pancreatitis
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Fluid Management in Acute Pancreatitis
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Acute pancreatitis is marked by inflammation of the pancreas, potentially leading to organ failure and pancreatic necrosis. Early management relies heavily on intravenous (IV) fluid resuscitation. Initiating fluid resuscitation at an early stage can enhance pancreatic perfusion and maintain adequate systemic circulation, reducing the risk of pancreatic necrosis, hypovolemic shock, and organ failure.1

Recently, a series of randomized controlled trials have provided a clearer understanding of the type and rate of fluid administration that is the most beneficial for patients with acute pancreatitis.2-4 The approach to managing fluids in cases of acute pancreatitis may vary depending on the severity of the condition and individual patient factors. Fluids should be prescribed considering their composition (type of fluid), dosing (rate of administration), goals, potential risks, and contraindications.2,3 Close monitoring and assessment are essential components of effective fluid management of acute pancreatitis.2

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