Acta Medica Medianae
Vol. 52, No 3, September, 2013
UDK 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)
 

Correspondence to:

Biljana Stošić

Faculty of Medicine

Bulevar dr Zorana Đinđića 81

18000 Niš, Srbia

E-mail: b.stosic@yahoo.com

Review article                                                                                               

UDC: 616.37-002.1-08

doi:10.5633/amm.2013.0308

Volume therapy in acute pancreatitis

Biljana Stošić¹, Radmilo Janković¹, Danijela Stanković², Ines Veselinović³

University of Niš  Faculty of Medicine, Niš, Serbia¹

Health Center Negotin, Negotin, Serbia²

Department of Anesthesiology and Intensive Care, Clinical Center Niš, Niš, Serbia³

Fundamental management is required soon after a diagnosis of acute pancreatitis has been made and includes monitoring of the conscious state, the respiratory and cardiovascular system, the urinary output, adequate fluid replacement and pain control, blood purification therapy and nutritional support. An adequate dose of fluid replacement is essential to stabilize cardiovascular dynamics and the dose should be adjusted while assessing circulatory dynamics constantly. Current clinical practice guidelines recommend aggressive fluid resuscitation despite limited prospective data. Fluid therapy remains the mainstay of early management of patients with acute pancreatitis and severe acute pancreatitis. High-level evidence is lacking to guide protocols for fluid resuscitation in patients presenting with acute pancreatitis. In those patients with severe acute pancreatitis, the available evidence indicates that controlled fluid resuscitation with crystalloids and colloids offers the best outcome. Hematocrit remains a useful marker to guide fluid resuscitation in acute pancreatitis. However, the timing and ideal “cut-off” level needs to be determined. Acta Medica Medianae 2013;52(3):55-60.

      Key words: acute pancreatitis,  guidelines, resuscitation