Early fluid resuscitation and organ protection in severe acute pancreatitis        LI Shuang-ling*, XIE Min, YANG Yin-mo. *Department of Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
Corresponding author: YANG Yin-mo, E-mail: yangyinmo@263.com
Abstract    Fluid resuscitation and organ function protection are two key steps in the early treatment of severe acute pancreatitis (SAP). Fluid resuscitation should be evaluated immediately upon diagnosis of SAP, especially in patients with shock or dehydration. Equilibrium fluid is the preferred recommended fluid for resuscitation, and lactate Ringer's fluid is commonly used. Albumin may be used when receiving large amounts of crystalloid. The initial liquid rate and dosage of fluid resuscitation should be determined in combination with the resuscitation target and monitoring, and titrated liquid resuscitation should be carried out by the principles of individualization, precision, and restriction to avoid overload. Early organ dysfunction affects the prognosis of SAP, and early prophylaxis, detection, intervention, and protection are emphasized to prevent the occurrence and progression of multiple organ dysfunction. Prevention is more important than treatment. Early monitoring in the ICU, standardized fluid resuscitation, organ function support and comprehensive medical treatment are more important. Management measures include etiological treatment, early fluid resuscitation and circulation support, regulation of inflammatory response, improvement of intestinal barrier function, blood purification therapy, early respiratory support, kidney support, anticoagulation, brain protection, infection control, analgesia and sedation.