Document Detail

Early fluid resuscitation reduces morbidity among patients with acute pancreatitis.
MedLine Citation:
PMID:  21554987     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Early fluid resuscitation is recommended to reduce morbidity and mortality among patients with acute pancreatitis, although the impact of this intervention has not been quantified. We investigated the association between early fluid resuscitation and outcome of patients admitted to the hospital with acute pancreatitis.
METHODS: Nontransfer patients admitted to our center with acute pancreatitis from 1985-2009 were identified retrospectively. Patients were stratified into groups on the basis of early (n = 340) or late resuscitation (n = 94). Early resuscitation was defined as receiving ≥one-third of the total 72-hour fluid volume within 24 hours of presentation, whereas late resuscitation was defined as receiving ≤one-third of the total 72-hour fluid volume within 24 hours of presentation. The primary outcomes were frequency of systemic inflammatory response syndrome (SIRS), organ failure, and death.
RESULTS: Early resuscitation was associated with decreased SIRS, compared with late resuscitation, at 24 hours (15% vs 32%, P = .001), 48 hours (14% vs 33%, P = .001), and 72 hours (10% vs 23%, P = .01), as well as reduced organ failure at 72 hours (5% vs 10%, P < .05), a lower rate of admission to the intensive care unit (6% vs 17%, P < .001), and a reduced length of hospital stay (8 vs 11 days, P = .01). Subgroup analysis demonstrated that these benefits were more pronounced in patients with interstitial rather than severe pancreatitis at admission.
CONCLUSIONS: In patients with acute pancreatitis, early fluid resuscitation was associated with reduced incidence of SIRS and organ failure at 72 hours. These effects were most pronounced in patients admitted with interstitial rather than severe disease.
Matthew G Warndorf; Jane T Kurtzman; Michael J Bartel; Mougnyan Cox; Todd Mackenzie; Sarah Robinson; Paul R Burchard; Stuart R Gordon; Timothy B Gardner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-04-08
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  9     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-11-15     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  705-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
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MeSH Terms
Fluid Therapy / methods*
Middle Aged
Pancreatitis, Acute Necrotizing / complications,  mortality,  pathology*,  therapy*
Retrospective Studies
Survival Analysis
Systemic Inflammatory Response Syndrome / epidemiology*,  prevention & control
Time Factors
Treatment Outcome
Grant Support
1K23DK088832-01/DK/NIDDK NIH HHS; K23 DK088832/DK/NIDDK NIH HHS; K23 DK088832-01/DK/NIDDK NIH HHS
Comment In:
Clin Gastroenterol Hepatol. 2012 Jan;10(1):95-6; author reply 96   [PMID:  21888883 ]
Clin Gastroenterol Hepatol. 2011 Aug;9(8):633-4   [PMID:  21421079 ]

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