Response and outcome from fluid resuscitation in acute pancreatitis: a prospective cohort study

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Tao JinJohn A Windsor

Abstract

Intravenous (IV) fluid resuscitation remains the cornerstone for early management of acute pancreatitis (AP), but many questions remain unanswered, including how to determine whether patients will benefit from additional fluids. The aim was to investigate the utility of serum biomarkers of responsiveness IV fluid resuscitation in patients with AP and systemic inflammatory response syndrome (SIRS). Eligible adult patients had abdominal pain for <36 h and ≥2 SIRS criteria. Mean arterial pressure (>65 mmHg) and urine output (>0.5 ml/kg/h) were used to assess responsiveness at 2 and 6-8 h after initiation of IV fluids. Comparison was made between responsive and refractory patients at time points for fluid volume, biomarkers and outcomes. At 2 h 19 patients responded to fluids (Group 1) while 4 were refractory (Group 2); at 6-8 h 14 responded (Group 3) and 9 were refractory (Group 4). No demographic differences between patient groups, but Group 4 had worse prognostic features than Group 3. Refractory patients received significantly more fluid (Group 4 mean 7082 ml vs. Group 3 5022 mL, P < 0.001) in first 24 h and had worse outcome. No significant differences in biomarkers between the groups. The serum biomarkers did not discriminate...Continue Reading

Citations

Feb 1, 2019·Current Treatment Options in Gastroenterology·Mahya FaghihVikesh K Singh
Aug 13, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Tao JinQing Xia
Dec 9, 2020·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
Feb 26, 2021·Evidence-based Complementary and Alternative Medicine : ECAM·Xiao-Lin YiWen-Fu Tang

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