Guidelines for the management of patients with severe acute pancreatitis, 2021 - 15/06/22
, Marc Garnier c, Karim Asehnoune d, e, Fanny Bounes f, g, Louis Buscail h, Jean-Baptiste Chevaux i, Claire Dahyot-Fizelier j, k, Lucie Darrivere l, Matthieu Jabaudon m, n, Olivier Joannes-Boyau o, Yoann Launey p, Eric Levesque q, r, Philippe Levy s, Philippe Montravers t, u, Laurent Muller v, Thomas Rimmelé w, x, Claire Roger v, y, Céline Savoye-Collet z, Philippe Seguin A, Jean-Pierre Tasu B, C, Ronan Thibault D, Geoffroy Vanbiervliet E, Emmanuel Weiss F, G, H, Audrey De Jong a, bAbstract |
Objective |
To provide guidelines for the management of the intensive care patient with severe acute pancreatitis.
Design |
A consensus committee of 22 experts was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline construction process was conducted independently of any industrial funding (i.e. pharmaceutical, medical devices). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised.
Methods |
The most recent SFAR and SNFGE guidelines on the management of the patient with severe pancreatitis were published in 2001. The literature now is sufficient for an update. The committee studied 14 questions within 3 fields. Each question was formulated in a PICO (Patients Intervention Comparison Outcome) format and the relevant evidence profiles were produced. The literature review and recommendations were made according to the GRADE® methodology.
Results |
The experts' synthesis work and their application of the GRADE® method resulted in 24 recommendations. Among the formalised recommendations, 8 have high levels of evidence (GRADE 1+/−) and 12 have moderate levels of evidence (GRADE 2+/−). For 4 recommendations, the GRADE method could not be applied, resulting in expert opinions. Four questions did not find any response in the literature. After one round of scoring, strong agreement was reached for all the recommendations.
Conclusions |
There was strong agreement among experts for 24 recommendations to improve practices for the management of intensive care patients with severe acute pancreatitis.
El texto completo de este artículo está disponible en PDF.Keywords : Guidelines, Severe acute pancreatitis, Acute respiratory distress syndrome, Sepsis, Intensive care unit, Critical care
Esquema
| ⋆ | Validated by the SFAR Clinical Guidelines Committee on the 24th of June 2021 and by the SFAR Board of Directors on the 30th of June 2021. |
| ⋆⋆ | Guidelines issued by the French Society of Anaesthesia and Intensive Care Medicine (Société française d’anesthésie et de réanimation - SFAR), in collaboration with: the French National Society of Gastroenterology (Société nationale française de gastro-entérologie - SNFGE), the French Association of Surgery (Association française de chirurgie - AFC), the French Society of Radiology (Société française de radiologie - SFR), the French Speaking Society of Clinical Nutrition and Metabolism (Société francophone de nutrition clinique et métabolisme - SFNCM), and the French Society of Digestive Endoscopy (Société française d’endoscopie digestive - SFED). |
Vol 41 - N° 3
Artículo 101060- juin 2022 Regresar al número
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