[Research advances in fluid therapy for severe acute pancreatitis]

Severe acute pancreatitis (SAP) is a condition with high mortality, characterized by persistent (>48 hours) organ dysfunction. Fluid therapy serves as the cornerstone of acute-phase management in SAP, crucial for reducing morbidity and mortality. In recent years, significant research progress has been made in the treatment concepts, methods, and strategies of fluid management for SAP patients, contributing to improved patient outcomes. Based on an understanding of the pathophysiological characteristics of SAP, it is important to recognize the significance of individualized fluid management strategies and to reasonably select the appropriate types and treatment methods of fluids for resuscitation. To achieve precise volume management, the fluid therapy for SAP patients requires the comprehensive integration of monitoring parameters, including clinical signs, laboratory markers, and invasive hemodynamic indicators, enabling dynamic assessment to avoid fluid overload. This approach is essential for continuously enhancing the efficacy and safety of fluid therapy in SAP. This review systematically summarizes recent advances in fluid management for SAP. It covers the pathophysiological mechanisms of fluid loss, individualized fluid management strategies, the selection of resuscitation fluid types and timing, goal-directed therapy, and monitoring methods. It aims to elucidate how optimized fluid resuscitation strategies can enhance organ perfusion while mitigating the risks of fluid overload and related complications, thereby providing a theoretical framework for precise, and individualized SAP fluid management protocols.