Effects of Fluid Resuscitation on the Occurrence of Organ Failure and Mortality in Patients With Acute Pancreatitis

Link to article at PubMed

Pancreas. 2020 Nov/Dec;49(10):1315-1320. doi: 10.1097/MPA.0000000000001681.


OBJECTIVES: Acute pancreatitis (AP) is a serious gastroenterological condition requiring urgent fluid resuscitation and emergent intensive care. However, the benefit of fluid resuscitation is inconsistent. Therefore, this study aimed to examine the effects of fluid resuscitation on the occurrence of organ failure and mortality in patients with AP.

METHODS: The data were retrospectively extracted from the Medical Information Mart for Intensive Care III 2002-2012 database. The fluid resuscitation and fluid balance were calculated at 12, 24, 36, and 48 hours after intensive care unit admission. Multivariate analysis models were used.

RESULTS: A total of 317 patients with AP were included. Odds of organ failure increased significantly with increased fluid input at 0 to 12 hours [adjusted odds ratio (aOR), 1.124; 95% confidence interval (CI), 1.015-1.244] and with increased fluid balance at 36 to 48 hours (aOR, 1.184; 95% CI, 1.009-1.389). Odds of in-hospital mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.201; 95% CI, 1.052-1.371). Odds of 30-day mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.189; 95% CI, 1.039-1.361).

CONCLUSIONS: Increased fluid balance was associated with increased risk of organ failure and mortality. Increased fluid output may decrease mortality.

PMID:33122519 | DOI:10.1097/MPA.0000000000001681

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