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Digestive Diseases and Sciences

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28-11-2023 | Acute Pancreatitis | Original Article

Comparison of Fluid Resuscitation with Lactate Ringer's Versus Normal Saline in Acute Pancreatitis: An Updated Meta-Analysis

Authors: Jiaze Hong, Qingyuan Li, Yiran Wang, Lizhi Xiang, Yifu Zhou, Mengke Fan, Rong Lin

Published in: Digestive Diseases and Sciences | Issue 1/2024

Abstract

Background

Fluid resuscitation is one of the main therapies for acute pancreatitis (AP). There is still no consensus on the type of fluid resuscitation. This study investigated the differences between lactate Ringer’s (LR) and normal saline (NS) in treating AP.

Methods

Two authors systematically searched Web of Science, Embase (via OVID), Cochrane Library, and PubMed to find all published research before July, 2023. The odds of moderately severe/severe AP and intensive care unit (ICU) admission are set as primary endpoints.

Results

This meta-analysis included 5 RCTs and 4 observational studies with 1424 AP patients in LR (n = 651) and NS (n = 773) groups. The results suggested that the odds of moderately severe/severe AP (OR 0.48; 95%Cl 0.34 to 0.67; P < 0.001) and ICU admission (OR 0.37; 95%Cl 0.16 to 0.87; P = 0.02) were lower in the LR group compared to NS group. In addition, the LR group had lower rates of local complications (OR 0.54; 95%Cl 0.32 to 0.92; P = 0.02), lower level of CRP, as well as a shorter hospital stay (WMD, − 1.09 days; 95%Cl − 1.72 to − 0.47 days; P < 0.001) than the NS group. Other outcomes, such as mortality, the rate of organ failure, SIRS, acute fluid collection, pancreatic necrosis, pseudocysts, and volume overload, did not differ significantly between two groups (P > 0.05).

Conclusions

LR is preferred over NS as it decreases the odds of moderately severe/severe AP, the rate of ICU admission, local complication, and length of hospital stay. However, large-scale RCT are lacking to support these evidence.

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Title: Comparison of Fluid Resuscitation with Lactate Ringer's Versus Normal Saline in Acute Pancreatitis: An Updated Meta-Analysis
Authors: Jiaze Hong
Qingyuan Li
Yiran Wang
Lizhi Xiang
Yifu Zhou
Mengke Fan
Rong Lin
Publication date: 28-11-2023
Publisher: Springer US
Keyword: Acute Pancreatitis
Published in: Digestive Diseases and Sciences / Issue 1/2024
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-023-08187-7

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