1. Quelle perfusion prescrire à la phase initiale de la pancréatite aiguë ?
- Author
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Dupont, Benoît, Chaigneau, Thomas, and Piquet, Marie-Astrid
- Subjects
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HEMODYNAMIC monitoring , *PANCREATIC diseases , *DISEASE management , *PANCREATITIS , *HEMODYNAMICS - Abstract
Acute pancreatitis is one of the main causes of hospitalization for gastroenterological reason in the world. To date, the management of this disease apart from the etiological treatment, remains symptomatic. The correction of the hypovolemia induced in pancreatitis, is a cornerstone of management. Some authors defend the concept that the fluid resuscitation could influence the severity of the disease by limiting pancreatic ischemia and peripheral hypo-perfusion at the origin of organ failure. However, recent data show that aggressive fluid resuscitation can induce deleterious effects, in particular -volume overload, without inflecting the natural history of the disease. If the volume and the optimal modalities remain to be defined, the speed of initiation of the infusions could condition its impact. To date, it seems reasonable to favor balanced crystalloids and in particular Ringer's Lactate, not to exceed 3 ml/kg/h without questioning the relevance of the prescription. It is crucial to evaluate early and regularly in order to adapt prescriptions to initial hemodynamic status of the patient and to his response to infusion. The development of simple and relevant hemodynamic monitoring tools in this indication is a major challenge for the future. This mini-review aims to detail the role of fluid resuscitation in acute pancreatitis, its modalities, the expected benefits and the limits of this therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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