Can vigorous fluid prevent complications of acute pancreatitis?
Research has been emphasizing the importance of vigorous fluid resuscitation but has failed to determine the amount of fluid that would fit be required. The ability of vigorous fluid resuscitation is to prevent complications of acute pancreatitis such as pancreatic necrosis, and organ failure has been suggested but has not been proven. There are also concerns about inadequate fluid resuscitation about inadequate blood flow to the microcirculation of the pancreas which would predispose to pancreatic necrosis and precipitate organ failure. On the other hand, overly aggressive fluid resuscitation might predispose to compartment syndrome, respiratory complications,иand possibly even increased infection and mortality. Recent studies have looked at the importance of early fluid resuscitation during the first 24 hours. The benefits of early fluid resuscitation compared with later resuscitation showed a decreased SIRS in the first 24 hours, reduced organ failure, a lower rate of admission to the intensive care unit, reduced length of hospital stay, but no decrease of mortality. The initial goal of fluid resuscitation is to restore circulating blood volume with the aim of improving peripheral tissue oxygenation. Clinical markers of adequate hemodynamic function are heart rate, blood pressure, respiratory rate, oxygen saturation and urine output. Urine output should be restored at above 0.5 mL/h/kg body weight. Hematocrit, blood urea nitrogen, creatinine, and lactate are laboratory markers of volemia and adequate tissue perfusion and should be monitored.