What is new in the management of acute pancreatitis in the intensive care unit?

Authors

  • Sebastien TANAKA Assistance Publique Hôpitaux de Paris, département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard, Paris, France
  • Gaelle FOUQUE Assistance Publique Hôpitaux de Paris, département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard, Paris, France
  • Kevin Boussion Assistance Publique Hôpitaux de Paris, département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard, Paris, France
  • Stefan Andrei 1. Assistance Publique Hôpitaux de Paris, département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard, 46 rue Henri Huchard, 75018 Paris, France. 2. Group of Data Modeling, Computational Biology and Predictive Medicine, Applied Mathematics, CNRS UMR 81987, INSERM U1024, IBENS, Ecole Normale Supérieure, Paris, France
  • Philippe Montravers 1. Assistance Publique Hôpitaux de Paris, département d’Anesthésie-Réanimation, CHU Bichat Claude-Bernard, 46 rue Henri Huchard, 75018 Paris, France. 2. Université Paris Cité, Paris, France. 3. INSERM UMR 1152, Physiopathologie et Epidémiologie des maladies respiratoires, Paris, France.

DOI:

https://doi.org/10.37051/mir-34-002081

Keywords:

acute pancreatitis , intensive care unit , pancreatic necrosis , infection, abdominal compartment syndrome

Abstract

Severe acute pancreatitis (AP), defined as persistent organ failure requiring Intensive Care Unit (ICU) hospitalization, accounts for some 15-20% of all AP. Few studies have evaluated specific therapies in these ICU patients, and many recommendations are extrapolated from the management of less severe AP patients, or from other ICU situations such as septic shock. This review of the literature focuses on the management of AP in ICU patients, and will cover a wide range of debated topics, including fluid challenge management, respiratory failure, acute kidney injury and, in particular, abdominal compartment syndrome, nutrition and analgesia. A section will be devoted to the microbiology of acute pancreatitis infections, including infection of pancreatitis necrosis, and antimicrobial therapy. Finally, the last part of the review will address the management of pancreatic necrosis, from endoscopic and/or radiological approaches to surgical therapies.

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Published

2025-12-08

How to Cite

TANAKA, S., FOUQUE, G., Boussion, K., Andrei, S., & Montravers, P. (2025). What is new in the management of acute pancreatitis in the intensive care unit?. Médecine Intensive Réanimation, 34(4). https://doi.org/10.37051/mir-34-002081

Issue

Vol. 34 No. 4 (2025)

Section

Update

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