Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Risk management in patients with severe acute pancreatitis. | Critical Care December 2004 Vol 8 No 6 Gerlach Commentary Risk management in patients with severe acute pancreatitis Herwig Gerlach Professor and Director Department of Anesthesiology Critical Care Medicine and Pain Management Vivantes - Klinikum Neukoelln Berlin Germany Corresponding author Herwig Gerlach Published online 8 November 2004 This article is online at http content 8Z6 430 2004 BioMed Central Ltd Related to Research by De Waele et al. see page 513 Critical Care 2004 8 430-432 DOI cc3007 Abstract Primary or secondary infection of necrotized areas by enteral bacteria is considered a primary cause of mortality in patients with severe acute pancreatitis SAP . Indeed 20-30 of patients die during the course of the disease from multiple organ dysfunction after infection. This is why strategies such as antibiotic prophylaxis and early surgical intervention are appealing but the controlled data that support these measures are insufficient. On the other hand environmental risk factors . smoking alcohol and genetic predisposition have been identified together these led to SAP being considered a multifactorial disease. However this description does not help the intensivist to assess risk in the individual patient. A number of prognostic factors in SAP have been identified and different scoring systems have been developed that include therapy-associated and patient-related factors. Nevertheless at present no prognostic model is available that takes into account all of these predictors. Moreover despite several attempts to create guideline-based strategies SAP is still characterized by rapidly progressive multiple organ failure and high mortality and both surgical and conservative therapies yield poor outcomes. This brief commentary highlights the most recent developments in risk management for patients with SAP. Keywords organ failure pancreatic necrosis predictors risk assessment severe acute pancreatitis .
