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.