Approach to the management of the adult patient with hypertriglyceridemic pancreatitis

HTGP: hypertriglyceridemic pancreatitis; TG: triglycerides; WBC: white blood cell; PaCO₂: partial pressure of carbon dioxide.
* Signs of worsening inflammation include:

• Temperature >38.5°C or <35.0°C
• Heart rate of >90 beats/min
• Respiratory rate of >20 breaths/min or PaCO₂ of <32 mmHg
• WBC count of >12,000 cells/mL, <4000 cells/mL, or >10% immature (band) forms

¶ As defined by the modified Marshall scoring system for organ dysfunction. Refer to UpToDate topic on hypertriglycerdemia-induced acute pancreatitis.
Δ Pharmacologic therapy to lower TG levels and dietary fat restriction are needed long-term to prevent recurrences of acute pancreatitis and prevent other complications of hypertriglyceridemia. Other nonpharmacologic interventions include restriction of fat content to 10 to 15% of the diet, weight loss in obese patients, aerobic exercise, avoidance of concentrated sugars and medications that raise serum triglyceride levels, and strict glycemic control in patients with diabetes.
◊ Based on serum glucose levels, intravenous glucose may be necessary in patients being treated with intravenous insulin.