Podcast 815: Fluid Resuscitation in Pancreatitis

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Historically, pancreatitis has been treated with aggressive IV fluid rehydration. Recently published data shows this may not be appropriate.</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">A randomized, controlled, multi-hospital trial evaluated outcomes for patients with acute pancreatitis receiving lactated Ringer’s solution   </span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Aggressive fluid resuscitation group received 20ml/kg bolus + 3ml/hour</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;"> </span><span style= "font-weight: 400;">Moderate fluid resuscitation groups received either 10 ml/kg bolus if hypovolemic or no bolus if normovolemic. Both moderate resuscitation groups received 1.5ml/hr.  </span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">The primary outcome was development of moderately severe or severe pancreatitis. 22.1% of aggressive fluid resuscitation and 17.3% of moderate fluid resuscitation patients developed primary outcome.</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">The safety outcome was fluid overload. Fluid overload developed in 20.5% of aggressive resuscitation group and only 6.3% of moderate resuscitation group.  </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">This trial was ended early due to differences in safety outcomes without obvious difference in primary outcome</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Overall, aggressive fluid resuscitation had no benefit in treatment of acute pancreatitis and providers should be aware of fluid overload risk.</span></li> </ul> <p> </p> <p><strong>References</str