BACKGROUND: Fluid therapy (FT) is a critical intervention in managing acute pancreatitis (AP). There is a paucity of evidence to guide FT and virtually no data on current prescribing practice. This survey aims to characterize current practice and opinion with regard to FT in AP throughout New Zealand. METHODS: Information was collected on fluid selection, administration, and goal-directed FT. The survey was distributed online and in print to all doctors employed in General Surgery Departments in New Zealand on 1 May 2012. Monthly email reminders were sent for 6 months. RESULTS: The overall response rate was 47 % (n = 190/408). Crystalloids were the preferred initial fluid for all categories of severity; however, colloid use increased with severity (p < 0.001). Fluid volume also increased with severity (p = 0.001), with 74 % of respondents prescribing >4 L for AP with organ failure (OF). Clinicians treating 26-50 patients per year with AP were less likely to prescribe colloid for AP with OF (8 vs 43 %) (p = 0.001). Rate of fluid administration in AP with OF varied according to physicians' seniority (p = 0.004); consultants prescribed >4 L more than other groups (83 vs 68 %). Only 17 % of respondents reported the use of guidelines. CONCLUSIONS: This survey reveals significant variation in prescription of FT for AP, and aggressive FT is commonly prescribed for AP with OF. There is little adherence to published guidelines or best available evidence.
BACKGROUND: Fluid therapy (FT) is a critical intervention in managing acute pancreatitis (AP). There is a paucity of evidence to guide FT and virtually no data on current prescribing practice. This survey aims to characterize current practice and opinion with regard to FT in AP throughout New Zealand. METHODS: Information was collected on fluid selection, administration, and goal-directed FT. The survey was distributed online and in print to all doctors employed in General Surgery Departments in New Zealand on 1 May 2012. Monthly email reminders were sent for 6 months. RESULTS: The overall response rate was 47 % (n = 190/408). Crystalloids were the preferred initial fluid for all categories of severity; however, colloid use increased with severity (p < 0.001). Fluid volume also increased with severity (p = 0.001), with 74 % of respondents prescribing >4 L for AP with organ failure (OF). Clinicians treating 26-50 patients per year with AP were less likely to prescribe colloid for AP with OF (8 vs 43 %) (p = 0.001). Rate of fluid administration in AP with OF varied according to physicians' seniority (p = 0.004); consultants prescribed >4 L more than other groups (83 vs 68 %). Only 17 % of respondents reported the use of guidelines. CONCLUSIONS: This survey reveals significant variation in prescription of FT for AP, and aggressive FT is commonly prescribed for AP with OF. There is little adherence to published guidelines or best available evidence.
Authors: Dileep N Lobo; Zeno Stanga; Mark M Aloysius; Catherine Wicks; Quentin M Nunes; Katharine L Ingram; Lorenz Risch; Simon P Allison Journal: Crit Care Med Date: 2010-02 Impact factor: 7.598
Authors: Enrique de-Madaria; Gema Soler-Sala; José Sánchez-Payá; Inmaculada Lopez-Font; Juan Martínez; Laura Gómez-Escolar; Laura Sempere; Cristina Sánchez-Fortún; Miguel Pérez-Mateo Journal: Am J Gastroenterol Date: 2011-08-30 Impact factor: 10.864
Authors: Lan Li; Tao Jin; Si Wen; Na Shi; Ruwen Zhang; Ping Zhu; Ziqi Lin; Kun Jiang; Jia Guo; Tingting Liu; Anthony Philips; Lihui Deng; Xiaonan Yang; Vikesh K Singh; Robert Sutton; John A Windsor; Wei Huang; Qing Xia Journal: Dig Dis Sci Date: 2020-01-07 Impact factor: 3.199
Authors: Tao Jin; Lan Li; Lihui Deng; Si Wen; Ruwen Zhang; Na Shi; Ping Zhu; Lan Lan; Ziqi Lin; Kun Jiang; Jia Guo; Tingting Liu; Anthony Philips; Xiaonan Yang; Vikesh K Singh; Robert Sutton; John A Windsor; Wei Huang; Qing Xia Journal: JGH Open Date: 2020-03-13