AIMS: Early aggressive fluid resuscitation in acute pancreatitis is frequently recommended but its benefits remain unproven. The aim of this study was to determine the outcomes associated with early fluid volume administration in the emergency room (FVER) in patients with acute pancreatitis. METHODS: A four-center retrospective cohort study of 1010 patients with acute pancreatitis was conducted. FVER was defined as any fluid administered from the time of arrival to the emergency room to 4 h after diagnosis of acute pancreatitis, and was divided into tertiles: nonaggressive (<500 ml), moderate (500 to 1000 ml), and aggressive (>1000 ml). RESULTS: Two hundred sixty-nine (26.6%), 427 (42.3%), and 314 (31.1%) patients received nonaggressive, moderate, and aggressive FVER respectively. Compared with the nonaggressive fluid group, the moderate group was associated with lower rates of local complications in univariable analysis, and interventions, both in univariable and multivariable analysis (adjusted odds ratio (95% confidence interval): 0.37 (0.14-0.98)). The aggressive resuscitation group was associated with a significantly lower need for interventions, both in univariable and multivariable analysis (adjusted odds ratio 0.21 (0.05-0.84)). Increasing fluid administration categories were associated with decreasing hospital stay in univariable analysis. CONCLUSIONS: Early moderate to aggressive FVER was associated with lower need for invasive interventions.
AIMS: Early aggressive fluid resuscitation in acute pancreatitis is frequently recommended but its benefits remain unproven. The aim of this study was to determine the outcomes associated with early fluid volume administration in the emergency room (FVER) in patients with acute pancreatitis. METHODS: A four-center retrospective cohort study of 1010 patients with acute pancreatitis was conducted. FVER was defined as any fluid administered from the time of arrival to the emergency room to 4 h after diagnosis of acute pancreatitis, and was divided into tertiles: nonaggressive (<500 ml), moderate (500 to 1000 ml), and aggressive (>1000 ml). RESULTS: Two hundred sixty-nine (26.6%), 427 (42.3%), and 314 (31.1%) patients received nonaggressive, moderate, and aggressive FVER respectively. Compared with the nonaggressive fluid group, the moderate group was associated with lower rates of local complications in univariable analysis, and interventions, both in univariable and multivariable analysis (adjusted odds ratio (95% confidence interval): 0.37 (0.14-0.98)). The aggressive resuscitation group was associated with a significantly lower need for interventions, both in univariable and multivariable analysis (adjusted odds ratio 0.21 (0.05-0.84)). Increasing fluid administration categories were associated with decreasing hospital stay in univariable analysis. CONCLUSIONS: Early moderate to aggressive FVER was associated with lower need for invasive interventions.
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: 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
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