Fluid resuscitation in acute pancreatitis

Table 3 Authors’ recommendations for fluid replacement in predicted severe or severe acute pancreatitis

Parameter	Recommendation
Fluid resuscitation	Necessary: the earlier the resuscitation, the better the outcome
Type of fluid	Colloids and/or crystalloids: Among crystalloids, lactate Ringer’s better than normal salineUse colloids especially when albumin < 2.0 g/dL or hematocrit < 35%
Amount of fluid	Total fluid in first 24 h: between 3 and 4 L, Not to exceed 4 L
Rate of infusion	Initial bolus 1000 mL over one hour followed by 3 mL/kg per hour (200 mL/h) for 24-48 h
Monitoring	Urine output > 0.5 mL/kg/h, hematocrit = 25% to 35%, drop in BUNCVP: Not good for monitoring due to third space loss and hypoalbuminemia
Duration of resuscitation	24-48 h, until signs of volume depletion disappear

BUN: Blood urea nitrogen; CVP: Central venous pressure.