Multiple organ support therapy for severe acute pancreatitis        MA Xiao-chun, LUAN Zheng-gang. Department of ICU, the First Hospital of China Medical University, Shenyang110001, China
Corresponding author: MA Xiao-chun，E-mail:xcma2972@sina.com
Abstract    Patients with acute pancreatitis should be hospitalized on principle. Crucial fundamental managements are required soon after a diagnosis of acute pancreatitis has been made and including monitoring of the conscious state, the respiratory and cardiovascular system, the urinary output, adequate fluid replacement and pain control. Along with such managements, etiologic diagnosis and severity assessment should be conducted. Patients with a diagnosis of severe acute pancreatitis (SAP) should be transferred to ICU where intensive respiratory and cardiovascular management as well as interventional treatment, blood purification therapy and nutritional support are available. Severity assessment should be conducted repeatedly at least within 48 h following diagnosis. An adequate dose of fluid replacement is essential to stabilize cardiovascular dynamics and the dose should be adjusted while assessing circulatory dynamics constantly. A large dose of fluid replacement is usually required in patients with SAP. Prophylactic antibiotic administration is recommended to prevent infectious complications in patients with SAP. Although the efficacy of intravenous administration of protease inhibitors is still a matter of controversy, there is a consensus that a large dose of a synthetic protease inhibitor should be given to patients with SAP in order to prevent organ failure and other complications. Enteral feeding is superior to parenteral nutrition when it comes to the nutritional support of patients with SAP. Continuous artery infusion and continuous blood purification can be used selectively for SAP.