7 research outputs found
New classifications of severity of acute pancreatitis: Validation of determinant-based and revision of the Atlanta classification
Early predictors and outcomes of fluid sequestration in acute pancreatitis: An international multicenter study
536 A Multicenter Study of Early Administration of Intravenous Fluid Bolus and Outcome in Acute Pancreatitis
633 Early Predictors and Outcomes of Fluid Sequestration in Acute Pancreatitis: An International Multicenter Study
Fluid resuscitation with lactated Ringer’s solution vs normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial
[Background] Little is known regarding the optimal type of fluid resuscitation in acute pancreatitis (AP).[Objective] The objective of this article was to compare the effect of lactated Ringer’s solution (LR) vs normal saline (NS) in the inflammatory response in AP.[Methods] We conducted a triple-blind, randomized, controlled trial. Patients ≥ 18 admitted with AP were eligible. Patients were randomized to receive LR or NS. Primary outcome variables were number of systemic inflammatory response syndrome (SIRS) criteria at 24 hours, 48 hours and 72 hours and blood C-reactive protein (CRP) levels at 48 hours and 72 hours. In vitro complementary experiments were performed to further explore the interaction between pH, lactate and inflammation.[Results] Nineteen patients receiving LR and 21 receiving NS were analyzed. The median (p25–p75) number of SIRS criteria at 48 hours were 1 (1–2) for NS vs 1 (0–1) for LR, p = 0.060. CRP levels (mg/l) were as follows: at 48 hours NS 166 (78–281) vs LR 28 (3–124), p = 0.037; at 72 hours NS 217 (59–323) vs LR 25 (3–169), p = 0.043. In vitro, LR inhibited the induction of inflammatory phenotype of macrophages and NF-κB activation. This effect was not observed when using Ringer’s solution without lactate, suggesting a direct anti-inflammatory effect of lactate.[Conclusions] Lactated Ringer’s is associated with an anti-inflammatory effect in patients with acute pancreatitis.The RCT was funded by AIGPA, an association of researchers in gastroenterology from the province of Alicante, Spain.
In vitro experiments were supported by a national Spanish
public grant, project FIS PI13/00019 from Instituto de Salud
Carlos III; L.B. is supported by a predoctoral fellowship from
Generalitat de Catalunya (AGAUR, FI DGR 2013).Peer reviewe