Acute pancreatitis (AP) is a common and potentially fatal acute illness for which there is no specific treatment. Gut injury in AP contributes to disease severity and worse outcome. Intravenous fluid resuscitation is the most important early intervention in AP, with the potential to prevent gut injury, but for which significant unanswered questions remain. This collaborative project will test ways to optimise resuscitation (by using haematocrit to direct it and by supplementing with ethyl pyruvate) and protect the gut (by a proven oral decoction of Chinese herbs) in experimental studies (Auckland) which will directly impact the design of a randomised clinical trial of optimised fluid resuscitation (Chengdu). The impact of this project will be far-reaching because of its relevance to many acute diseases, especially in high-risk groups (including Maori).