Augmented Renal Clearance in Severe Post-traumatic Acute Pancreatitis: A Case Report From the Intensive Care Unit of Treichville University Hospital

TL;DR

A young woman with severe acute pancreatitis and trauma developed augmented renal clearance, requiring adjusted antibiotic dosing for recovery.

Contribution

This is the first reported case of augmented renal clearance occurring in the context of severe acute pancreatitis.

Findings

Augmented renal clearance was confirmed through pharmacokinetic assessment in a patient with severe acute pancreatitis.

Optimized antibiotic dosing based on renal clearance improved clinical outcomes in this critically ill patient.

Abstract

Acute kidney injury (AKI) represents one of the most prevalent organ dysfunctions encountered in severe acute pancreatitis. Augmented renal clearance (ARC) is an emerging phenomenon in intensive care medicine, with younger age and traumatic injury recognized as significant predisposing factors. In contrast to AKI, this pathophysiological entity has not been previously documented in the context of severe acute pancreatitis. Herein, we present a case of a 20-year-old female who sustained blunt abdominal trauma resulting in hemoperitoneum consequent to hepato-pancreatico-renal injury. The postoperative course following initial exploratory laparotomy was complicated by secondary bacterial peritonitis and subsequent septic shock. Despite appropriate antimicrobial therapy and supportive care, persistent sepsis prompted consideration of ARC, subsequently confirmed through pharmacokinetic assessment. Therapeutic optimization of antibiotic dosing protocols yielded clinical improvement and successful resolution. This case report illustrates the potential occurrence of ARC in the setting of severe acute pancreatitis and highlights the importance of pharmacokinetic monitoring in critically ill patients.

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