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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]

Résumé: Les évaluations des risques sanitaires des substances chimiques considèrent de plus en plus fréquemment les expositions agrégées et/ou cumulées afin de caractériser de manière la plus réaliste les risques sanitaires pour la population. L'exposition environnementale aux substances chimiques via la poussière sédimentée sur les surfaces intérieures doit-elle être prise en compte et de quelle manière ? La population est exposée aux substances chimiques présentes dans la poussière sédimentée par ingestion, inhalation et contact cutané. L'ingestion semble la voie d'exposition la plus importante, et la seule à pouvoir être estimée au vu des connaissances actuelles. Pour la mesure, il est recommandé d'utiliser la technique de prélèvement par aspiration sur une surface déterminée, suivie d'un tamisage à 250 μm (taille maximum des particules adhérant aux mains) afin de documenter les concentrations massique et surfacique. La mesure de la bioaccessibilité orale permettrait de mieux estimer l'exposition mais les méthodes ne sont pas validées à ce jour pour la majorité des composés. Les valeurs guides pour les poussières intérieures (VGPI) sont pertinentes si l'exposition via la poussière est non négligeable pour une fraction de la population. Elles pourraient être élaborées simplement en allouant à la poussière une fraction de la valeur toxicologique de référence. Health risk assessments of chemical substances consider aggregate and/or cumulative exposures in order to characterise population health risks realistically. Should environmental exposure to chemical substances via indoor settled dust be taken into account and if so, how? Exposure to the chemicals in settled dust can occur through ingestion, inhalation, and dermal contact. Ingestion appears to be the most important route of exposure, and the only one that can be estimated from current knowledge. The recommended measurement technique is sampling by vacuuming a given surface, then sieving the dust at 250 μm (maximum size of the particles adhering to the hands) to document the mass and surface concentrations. Oral bioaccessibility would provide a better exposure estimate, but its methods have not yet been validated for most compounds. Guideline values for indoor dust are relevant if exposure via dust is non-negligible for a fraction of the population. They could be developed by simply allocating a fraction of the toxicological reference value to dust. [ABSTRACT FROM AUTHOR]