Article Dans Une Revue Anaesthesia Critical Care & Pain Medicine Année : 2022

Guidelines for the management of patients with severe acute pancreatitis, 2021

1 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 GRC 29 - ARPE - Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire
4 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
5 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
6 Pôle Anesthésie Réanimation [CHU de Toulouse]
7 Service de Gastroentérologie et pancréatologie [CHU Toulouse]
8 Service d'Hépato-gastro-entérologie [CHRU Nancy]
9 PHAR2 [Poitiers] - Pharmacologie des anti-infectieux et antibiorésistance [U 1070]
10 Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière]
11 Pôle Médecine Péri-opératoire [CHU Clermont-Ferrand]
12 Centre médico chirurgical Magellan - Hôpital Haut-Lévêque - CHU de Bordeaux
13 Service d'Anesthésie Réanimation [Rennes]
14 Hôpital Henri Mondor
15 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
16 PHERE (UMR_S_1152 / U1152) - Physiopathologie et Epidémiologie des Maladies Respiratoires
17 PI3 - Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression
18 LITIS - Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes
19 LaTIM - Laboratoire de Traitement de l'Information Medicale
20 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
21 NuMeCan - Nutrition, Métabolismes et Cancer
22 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
Yoann Launey
Philippe Levy
  • Fonction : Auteur
Laurent Muller
  • Fonction : Auteur
Claire Roger
  • Fonction : Auteur
Philippe Seguin
  • Fonction : Auteur
Geoffroy Vanbiervliet

Résumé

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.

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Dates et versions

hal-03683080 , version 1 (31-05-2022)

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Samir Jaber, Marc Garnier, Karim Asehnoune, Fanny Bounes, Louis Buscail, et al.. Guidelines for the management of patients with severe acute pancreatitis, 2021. Anaesthesia Critical Care & Pain Medicine, 2022, 41 (3), pp.101060. ⟨10.1016/j.accpm.2022.101060⟩. ⟨hal-03683080⟩
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