The Curbsiders Internal Medicine Podcast

#327 Acute Pancreatitis

33 snips
Apr 4, 2022
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INSIGHT

Revised Atlanta Classification Value

  • Classic Ranson or APACHE scores have limited specificity and low positive predictive value in pancreatitis.
  • The revised Atlanta classification is simpler and more practical for assessing severity and guiding management.
ADVICE

Avoid Trending Lipase

  • Avoid trending lipase to assess disease severity or improvement.
  • Clinical evaluation of organ function and patient status is far more valuable than lipase trends.
ADVICE

Fluid Choice and Rate

  • Use lactated Ringer's solution preferentially for fluid resuscitation in acute pancreatitis.
  • Give 5-10 mL/kg/hour early in the first 24-48 hours to prevent progression to necrotizing pancreatitis.
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