Acute pancreatitis in the critical care setting: A review of assessment and intervention strategies

Abstract

The incidence of acute pancreatitis (AP), a condition characterized by inflammation in the pancreas, has been increasing globally and is associated with several complications. This review elaborated on the etiology, clinical presentation, severity assessment, and treatment modalities of AP, mainly in the critical care setting. Patients with severe AP, as indicated by organ failure (>48 hours from onset), warrant treatment in the intensive care unit setting. The most common etiologies, biliary disease and alcohol consumption, and the advanced diagnostic tools used for the identification of the cause are highlighted. Different severity assessment tools are utilized for grading the severity of the disease, predicting patient outcomes, determining the associated risk, and guiding treatment decisions. The treatment interventions comprise various approaches, such as anti-infective therapy enteral nutrition, analgesics for pain, or minimally invasive surgical procedures, thereby demonstrating an evolving landscape of AP management. Furthermore, various complications such as necrosis, organ failure, and hemorrhage, necessitate disease monitoring and differential diagnosis and are crucial for optimal management of patients. Novel treatment modalities and advancements in multidisciplinary care emphasize the potential for reducing the burden of AP in critical care settings.