Pancreatitis

One or both of the following:

  • CT scan with gas

  • Percutaneous aspirate or surgical specimen with organisms evident on Gram stain or culture

Pancreatitis associated with one or more of the following:

  • 30% pancreatic necrosis

  • APACHE II ≥ 9

  • More than 3 Ranson’s criteria

Zero Hours

  • Age > 55

  • WBC > 16,000/mm³

  •  Blood glucose > 200 mg/dL

  • Lactate dehydrogenase > 350 U/L

  • Aspartate aminotransferase
    (AST) > 250 U/L

48 Hours

  • Hematocrit: Fall by ≥ 10%

  • Serum calcium < 8 mg/dL

  • pO₂ < 60 mmHg

  • Base deficit > 4 MEq/L

  • Fluid sequestration > 6000 mL

  • Blood urea nitrogen (BUN): Increase by ≥ 5 mg/dL despite fluids

  •  Lack of utility of prophylactic antibiotics: Ann Surg 2007;245:674.

  •  Guidelines for management of SAP: Crit Care Med 2004;32:2524.

  •  Ranson’s criteria: Surg Gyneecol Obstet 1974;139:69.