Admission, management and outcomes of acute pancreatitis in intensive care

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Excerpt

Despite a better understanding of the underlying pathophysiology of severe and critical acute pancreatitis (AP),1 this subgroup of patients remains a major clinical and economic challenge.
In 2004, an audit from the same institution was published2 on the management and outcomes of 112 patients with AP admitted to the intensive care unit (ICU) between 1988 and 2001. This included mostly patients with severe and critical AP, but not all. New approaches to management were adapted, including enteral feeding and abdominal decompression, but there was no reduction in the length of ICU stay or mortality, which was 31%.
More recent trends in the management of AP have included admitting all patients with predicted and actual severe AP to intensive care or high dependency units (henceforth ‘ICU’), delaying the index computed tomography (CT) scan, recognizing the primacy of enteral (including gastric) nutrition, avoiding prophylactic antibiotics3 and treating local complications by the ‘step‐up’ approach.4
The aim of this study was to update the previous audit and document the evolution in management and outcomes.

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