Faster discharge with lactated ringers than normal saline in first 72 h of acute pancreatitis: A multicenter...

Area of Science:

• Pediatric critical care medicine
• Gastroenterology
• Clinical nutrition

Background:

• Data-driven strategies for pediatric acute pancreatitis (AP) are scarce.
• Adult studies suggest lactated Ringer (LR) solution may offer benefits over normal saline (NS) in AP management.
• Pediatric-specific evidence comparing LR and NS for AP is lacking.

Purpose of the Study:

• To evaluate the efficacy of LR versus NS in the initial 48 hours of pediatric AP episodes.
• To compare key clinical and laboratory outcomes between LR and NS treatment groups.

Main Methods:

• A multisite randomized controlled trial involving 76 pediatric patients with AP.
• Patients were randomized to receive either LR or NS exclusively for the first 48 hours.
• Primary outcome was serial C-reactive protein (CRP) levels; secondary outcomes included length of stay (LOS), time to feeds, and development of severe AP (SAP).

Main Results:

• No significant differences in CRP levels at 24 or 48 hours between the LR and NS groups.
• No significant differences observed in BUN, amylase, lipase, SIRS development, or progression to SAP.
• A higher proportion of patients receiving LR were discharged before 48 hours (32% vs. 13%) and within 72 hours (p=0.02).

Conclusions:

• LR administration in pediatric AP was associated with a faster discharge rate within 72 hours compared to NS.
• LR did not demonstrate significant differences in inflammatory markers or disease severity compared to NS.
• The accelerated discharge associated with LR may have implications for reducing hospitalization duration and healthcare costs.