Early crystalloid fluid volume management in acute pancreatitis: Association with mortality and organ failure

Kazuaki Kuwabara, Shinya Matsuda, Kiyohide Fushimi, Koichi B. Ishikawa, Hiromasa Horiguchi, Kenji Fujimori

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Aims: Guidelines recommend aggressive fluid resuscitation in patients with acute pancreatitis (AP) to minimize organ failure. This study aimed to determine whether early crystalloid fluid management is associated with mortality and/or critical care. Methods: 9,489 AP patients aged ≥18 years were categorized into four study groups: ventilation, hemodialysis, a combination of ventilation and hemodialysis, and neither ventilation nor hemodialysis. We analyzed demographics, mortality, comorbidities, complications, AP severity, surgery of the biliary/pancreatic system, and fluid volume (FV) during the initial 48 h (FV48) and during hospitalization (FVH), and calculated the FV ratio (FVR) as FV48/FVH. The impact of FV48 and FVR on mortality and the care process was assessed according to AP severity. Results: 1.1% of AP patients received ventilation, 1.7% received hemodialysis and 1.0% received both treatments. FV48 and FVR were higher in patients requiring ventilation compared with those not requiring ventilation. A high FV48 increased mortality and a high FVR decreased mortality in patients with severe AP. A high FV48 required ventilation in patients with severe AP, which was independently associated with mortality. Conclusion: Since relatively too much or too little early FV is associated with mortality, FV should be continuously monitored and managed according to AP severity.

Original languageEnglish
Pages (from-to)351-361
Number of pages11
JournalPancreatology
Volume11
Issue number3
DOIs
Publication statusPublished - 2011 Sep
Externally publishedYes

Keywords

  • Acute pancreatitis therapy
  • Critical care
  • Fluid volume management
  • Mortality

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

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