de-Madaria et al identified early risk factors for fluid sequestration in a patient with acute pancreatitis. Excessive fluid sequestration during the first 48 hours after hospital admission is associated with a worse prognosis. The authors are from Hospital General Universitario de Alicante, Brigham and Women's Hospital, Kaiser Permanente Los Angeles Medical Center and the Johns Hopkins Medical Institutions.
Fluid sequestration is the difference between the fluid administered to the patient and fluid loss (based on measured output and insensible loss)
fluid volume sequestered in liters =
= (total fluid input in liters) - (total fluid output)
Risk factors for increased fluid sequestration during the first 48 hours after hospital admission:
(1) age < 40 years
(2) alcoholic pancreatitis
(3) hematocrit > 44 percent
(4) glucose > 150 mg/dL
(5) presence of systemic inflammatory response syndrome (SIRS) in the ED
In the discussion the authors also indicate that acute pancreatic necrosis was associated with retroperitoneal fluid sequestration.
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