Aggressive vs. Moderate Fluid Resuscitation in Acute Pancreatitis
Is early aggressive fluid resuscitation more effective than moderate fluid resuscitation in managing acute pancreatitis?
- Randomized controlled trial
Patients presenting with acute pancreatitis
- Total number of patients studied: 249
- Inclusion criteria: Patients presenting with acute pancreatitis
- Exclusion criteria: Not specified in the provided text
Interventions
- Experimental group: Early aggressive fluid resuscitation with a bolus of 20 ml per kilogram of body weight, followed by 3 ml per kilogram per hour
- Control group: Moderate fluid resuscitation with a bolus of 10 ml per kilogram in patients with hypovolemia or no bolus in patients with normovolemia, followed by 1.5 ml per kilogram per hour in all patients in this group
Primary outcome: The development of moderately severe or severe pancreatitis during the hospitalization
Safety outcomes
| Outcome | Aggressive Fluid Resuscitation | Moderate Fluid Resuscitation |
|---|---|---|
| Incidence of Fluid Overload (%) | 20.5 | 6.3 |
| Median Duration of Hospitalization (Days) | 6 | 5 |
| Underwent Orotracheal Intubation (# of patients) | 1 | 0 |
Conclusion
In patients with acute pancreatitis, early aggressive fluid resuscitation was associated with a higher incidence of fluid overload and did not show an improvement in clinical outcomes when compared with moderate fluid resuscitation. The study was halted due to significantly worse safety outcomes in the aggressive-resuscitation group.