HUN4446 acute apncreatitis

HUN4446 acute apncreatitis - resume oral intake as...

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hypotension fever diagnostic tests: magnetic resonance imaging cholangiopanc reatography CT scan ultrasound abdominal/chest xray laboratory tests/findings: increased serum amylase (>250 U/L) increased serum lipase (>110 U/L) increased C-reactive protein (CRP, >15 at 48 h=severe) elevated plasma glucose (>200 mg/dl) elevated WBC count (>10000 cells/mm3) increased serum bilirubin, AST, ALT, LDH hyperTG (some cases) hypoCa, hypoMg, hypoK (varies) hypoalbuminemia Mild acute pancreatitis: Ranson's score 0-2 APACHE II < 9 No organ failure Severe acute pancreatitis Ranson's >/= 3 APACHE II>/= 10 organ failure with or without pancreatic necrosis CRP >15mg/dl at 48 h >21 mg/dl days 1-4 12 mg/dl day 7 complications sepsis/infection pseudocysts abscess organ dysfunction death nutrition management (mild) NPO; IV fluids NG suction (pts w/ obstruction; protracted vomiting), need to maintain hydration status
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Unformatted text preview: resume oral intake as indicated by medical status (usually within 1 wk) medical status indicators of readiness when oral intake can be resumed, recommend (initially) easily digestible low fat diet adequate protein increased kcals small frequent meals no alcohol (permanently, if pancreatitis is alcohol related) nutrition management NPO; IV fluids tube feeding if GI tract functional tip of tube in jejunum (beyond ligament of Trietz) some studies demonstrate tolerance of NG feedings peptide-based/low fat, MCT-based contraindications ischemic bowel; prolonged SI ileus high output fistula/obstruction that cant be bypassed insufficient absorptive capacity nutrition management (severe):...
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HUN4446 acute apncreatitis - resume oral intake as...

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