الإنعاش بالسوائل الوريدية في التهاب البنكرياس الحاد: علاج مبني على الأدلة

References

DOI: 10.14309/ajg.0000000000002645

• We suggest moderately aggressive fluid resuscitation for patients with AP.
• Additional boluses will be needed if there is evidence of hypovolemia.
• We suggest using lactated Ringer solution over normal saline for intravenous resuscitation in AP.
• From this study, we can conclude that in patients with no evidence of hypovolemia, an initial resuscitation rate of no more than 1.5 mL/kg of body weight per hour should be administered.
• However, in patients with hypovolemia, clinicians should administer a bolus of 10 mL/kg.
• While the presence of hypovolemia might demand higher amounts and rates of hydration, most patients with AP will likely benefit from 3-4 L the first 24 hours, depending on body mass index.
• Fluid volumes need to be reassessed at frequent intervals within 6 hours of presentation and for the next 24-48 hours with a goal to decrease the BUN.
• In general, intravenous hydration providing for a decrease in the HCT (hemodilution) and/or decreased BUN (increased renal perfusion) have been shown to be associated with decreased morbidity and mortality.