Fluid resuscitation in acute pancreatitis: Normal saline or lactated Ringer's solution?

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Internal Medicine

Background:

• Acute pancreatitis (AP) management involves aggressive fluid resuscitation.
• The choice of intravenous fluid, such as Ringer's lactate (RL) or normal saline (NS), may influence patient outcomes.
• Understanding the optimal fluid choice is crucial for improving AP treatment strategies.

Purpose of the Study:

• To evaluate the impact of Ringer's lactate (RL) solution administration on clinical outcomes in patients with acute pancreatitis (AP).
• To compare the efficacy of RL versus normal saline (NS) in managing AP severity and complications.

Main Methods:

• A retrospective study of 103 patients diagnosed with AP within 48 hours of presentation.
• Patients were classified into mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP) based on the revised Atlanta criteria.
• Fluid resuscitation was administered using either RL (1-RL group) or NS (2-NS group), with comparable total fluid volumes.

Main Results:

• No significant differences were observed in the distribution of AP severity between the RL and NS groups (P = 0.187).
• Outcomes including pancreatic necrosis, need for enteral nutrition, mortality, and hospital stay duration showed no statistically significant differences between the groups.
• Logistic regression analysis supported the findings, indicating no clear advantage of RL over NS.

Conclusions:

• The administration of Ringer's lactate solution in the initial phase of acute pancreatitis did not demonstrate improved clinical outcomes compared to normal saline.
• Current evidence does not support a preferential use of RL over NS for fluid resuscitation in AP based on this study's findings.
• Further prospective studies may be warranted to definitively establish the role of different fluid types in AP management.