Nonaggressive Versus Aggressive Intravenous Fluid Therapy in Acute Pancreatitis With More Than 24 Hours From Disease Onset: A Randomized Controlled Trial

Pancreas. 2020 Apr;49(4):579-583. doi: 10.1097/MPA.0000000000001528.

Abstract

Objective: This study aimed to compare a "nonaggressive" hydration versus an "aggressive" hydration using Hartmann's solution in patients with acute pancreatitis (AP) with more than 24 hours from disease onset.

Methods: We included 88 patients with AP with more than 24 hours from disease onset, and were randomized into 2 groups. Group I (n = 45) received a nonaggressive hydration (Hartmann's solution at 1.5 mL kg h for the first 24 hours and 30 mL kg during the next 24 hours), and group II (n = 43) received an aggressive hydration (bolus of Hartmann's solution 20 mL kg, followed by an infusion of 3 mL kg h for the first 24 hours and then 30 mL kg for the next 24 hours).

Results: The mean volume of fluid administered was greater in group II (P < 0.001). We did not find differences when comparing both groups in reference to persistent systemic inflammatory response syndrome (P = 0.528), pancreatic necrosis (P = 0.710), respiratory complications (P = 0.999), acute kidney injury (P = 0.714), or length of hospital stay (P = 0.892).

Conclusions: Our study suggests that the clinical evolution of patients with AP with more than 24 hours from disease onset is similar using an aggressive or nonaggressive hydration.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Kidney Injury / etiology
  • Administration, Intravenous
  • Adult
  • Contrast Media
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pancreatitis / complications
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / therapy*
  • Pancreatitis, Acute Necrotizing / etiology
  • Respiration Disorders / etiology
  • Ringer's Lactate / administration & dosage*
  • Systemic Inflammatory Response Syndrome / etiology
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Contrast Media
  • Ringer's Lactate