AIMS: Guidelines recommend aggressive fluid resuscitation in patients with acute pancreatitis (AP) to minimize organ failure. This study aimed to determine whether early crystalloid fluid management is associated with mortality and/or critical care. METHODS: 9,489 AP patients aged ≥18 years were categorized into four study groups: ventilation, hemodialysis, a combination of ventilation and hemodialysis, and neither ventilation nor hemodialysis. We analyzed demographics, mortality, comorbidities, complications, AP severity, surgery of the biliary/pancreatic system, and fluid volume (FV) during the initial 48 h (FV48) and during hospitalization (FVH), and calculated the FV ratio (FVR) as FV48/FVH. The impact of FV48 and FVR on mortality and the care process was assessed according to AP severity. RESULTS: 1.1% of AP patients received ventilation, 1.7% received hemodialysis and 1.0% received both treatments. FV48 and FVR were higher in patients requiring ventilation compared with those not requiring ventilation. A high FV48 increased mortality and a high FVR decreased mortality in patients with severe AP. A high FV48 required ventilation in patients with severe AP, which was independently associated with mortality. CONCLUSION: Since relatively too much or too little early FV is associated with mortality, FV should be continuously monitored and managed according to AP severity. and IAP.
AIMS: Guidelines recommend aggressive fluid resuscitation in patients with acute pancreatitis (AP) to minimize organ failure. This study aimed to determine whether early crystalloid fluid management is associated with mortality and/or critical care. METHODS: 9,489 AP patients aged ≥18 years were categorized into four study groups: ventilation, hemodialysis, a combination of ventilation and hemodialysis, and neither ventilation nor hemodialysis. We analyzed demographics, mortality, comorbidities, complications, AP severity, surgery of the biliary/pancreatic system, and fluid volume (FV) during the initial 48 h (FV48) and during hospitalization (FVH), and calculated the FV ratio (FVR) as FV48/FVH. The impact of FV48 and FVR on mortality and the care process was assessed according to AP severity. RESULTS: 1.1% of AP patients received ventilation, 1.7% received hemodialysis and 1.0% received both treatments. FV48 and FVR were higher in patients requiring ventilation compared with those not requiring ventilation. A high FV48 increased mortality and a high FVR decreased mortality in patients with severe AP. A high FV48 required ventilation in patients with severe AP, which was independently associated with mortality. CONCLUSION: Since relatively too much or too little early FV is associated with mortality, FV should be continuously monitored and managed according to AP severity. and IAP.
Authors: Cong Feng; Xuan Su; Xuan Zhou; Li-Li Wang; Bei Li; L I Chen; Fa-Qin Lv; Tan-Shi Li Journal: Exp Ther Med Date: 2015-02-03 Impact factor: 2.447
Authors: Gautham Srinivasan; L Venkatakrishnan; Swaminathan Sambandam; Gursharan Singh; Maninder Kaur; Krishnaveni Janarthan; B Joseph John Journal: J Family Med Prim Care Date: 2016 Oct-Dec
Authors: Andrea Crosignani; Stefano Spina; Francesco Marrazzo; Stefania Cimbanassi; Manu L N G Malbrain; Niels Van Regenemortel; Roberto Fumagalli; Thomas Langer Journal: Ann Intensive Care Date: 2022-10-17 Impact factor: 10.318