Sep 26, 2022
Contributor: Aaron Lessen, MD
- Historically, pancreatitis has been treated
with aggressive IV fluid rehydration. Recently published data shows
this may not be appropriate.
- A randomized, controlled, multi-hospital trial
evaluated outcomes for patients with acute pancreatitis receiving
lactated Ringer’s solution
- Aggressive fluid resuscitation group received
20ml/kg bolus + 3ml/hour
- Moderate fluid resuscitation groups received
either 10 ml/kg bolus if hypovolemic or no bolus if normovolemic.
Both moderate resuscitation groups received
- The primary outcome was development of
moderately severe or severe pancreatitis. 22.1% of aggressive fluid
resuscitation and 17.3% of moderate fluid resuscitation patients
developed primary outcome.
- The safety outcome was fluid overload. Fluid
overload developed in 20.5% of aggressive resuscitation group and
only 6.3% of moderate resuscitation group.
- This trial was ended early due to differences
in safety outcomes without obvious difference in primary
- Overall, aggressive fluid resuscitation had no
benefit in treatment of acute pancreatitis and providers should be
aware of fluid overload risk.
de-Madaria E, Buxbaum JL,
Maisonneuve P, et al. Aggressive or Moderate Fluid Resuscitation in
Acute Pancreatitis. N
Engl J Med.
Summarized by Kirsten
Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks,
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