What Is the Treatment of Acute Pancreatitis? Goal-Directed Fluid Therapy and Early Oral Feeding
Current evidence-based management of acute pancreatitis centres on two concurrent priorities: targeted intravenous fluid administration guided by clinical response, and a proactive nutritional approach — replacing the older default of keeping the patient strictly nil per os.
Treatment Approach
Management centres on goal-directed intravenous fluid therapy titrated to specific physiological targets, paired with a structured approach to early oral nutrition — the full protocol defines the complete algorithm and the decision points for both interventions.
Clinical Goals Monitored
Adequacy of perfusion is assessed using a defined set of clinical and biochemical markers:
References
DOI: 10.1053/j.gastro.2018.01.032
- In patients with AP, the AGA suggests using goal-directed therapy for fluid management.
- Goal-directed therapy is generally defined as the titration of intravenous fluids to specific clinical and biochemical targets of perfusion (eg, heart rate, mean arterial pressure, central venous pressure, urine output, blood urea nitrogen concentration, and hematocrit).
- In patients with AP, the AGA recommends early (within 24 hours) oral feeding as tolerated rather than keeping the patient nil per os.
- Based on these studies, the AGA recommends initiation of early oral feeding (generally within 24 hours) instead of keeping patients NPO.