Large volume fluid resuscitation for severe acute pancreatitis tied to lower mortality

29 Apr 2019
Large volume fluid resuscitation for severe acute pancreatitis tied to lower mortality

Administration of a large fluid volume within the first 24 hours may reduce mortality in patients with severe acute pancreatitis (SAP), suggests a Japan study.

A total of 1,097 patients were analysed. The mean fluid volume administered was 5,618±3,018 mL, with 708 patients stratified into the fluid <6,000 mL group and 389 into the fluid ≥6,000 mL group.

There was a 12.3-percent in-hospital mortality overall. A significantly higher mortality was recorded in the fluid ≥6,000 mL group than in the fluid <6,000 mL group (univariable analysis, 15.9 percent vs 10.3 percent; p<0.05).

Multivariable logistic regression analysis revealed a significant association between administration of ≥6,000 mL of fluid within the first 24 hours and reduced mortality (odds ratio, 0.58; p<0.05). There was neither a significant association between the administered fluid volume and pancreatic infection nor between the volume administered and the need for surgical intervention.

An earlier study showed that early moderate-to-aggressive fluid volume administration in the emergency room resulted in a lower need for invasive interventions. [United European Gastroenterol J 2017;5:491-498]

To assess the link between the volume of fluid administered and clinical outcomes in SAP patients, the authors conducted a multicentre retrospective study at 44 institutions in Japan. They stratified patients into two groups: administered fluid volume <6,000 and ≥6,000 mL in the first 24 hours.

Multivariable logistic regression analysis was used to evaluate the association between the two groups and clinical outcomes. In-hospital mortality was the primary outcome, while incidence of pancreatic infection and the need for surgical intervention were the secondary outcomes.

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