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!