Acute Pancreatitis – Dr Winters

IVF recommendations:  5-10 mL/kg crystalloid (LR may be slightly better at preventing SIRS than NS) for the first 12-24 hours.

Yes, this is a lot of fluid!

Rate of fluid resuscitation should be adjusted based on clinical assessment, BUN and HCT:

  • Goal HR < 120/min
  • MAP 65-85 mmHg
  • If BUN is increasing or staying the same, INCREASE the IVF rate!  (High BUN predicts mortality.)
  • Persistent hemoconcentration at 24 hours is associated with necrotizing pancreatitis.  Get the HCT down!

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