Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review
<b>Background/Objectives:</b> Acute pancreatitis (AP) is an inflammatory condition with diverse origins, often resulting in significant morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiorgan failure. Fluid resuscitation is pivotal in early management...
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MDPI AG
2025-03-01
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| author | Cristian-Nicolae Costea Cristina Pojoga Andrada Seicean |
| author_facet | Cristian-Nicolae Costea Cristina Pojoga Andrada Seicean |
| author_sort | Cristian-Nicolae Costea |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Acute pancreatitis (AP) is an inflammatory condition with diverse origins, often resulting in significant morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiorgan failure. Fluid resuscitation is pivotal in early management, and it is aimed at preventing hypovolemia-induced ischemia and necrosis. This review evaluates fluid therapy strategies in AP, including fluid types, resuscitation rates, and clinical outcomes. <b>Methods:</b> This systematic review was conducted in January 2025 using databases such as PubMed, Medline, and Google Scholar, focusing on studies published between 2010 and 2024. Search terms included “acute pancreatitis”, “fluid resuscitation”, and related keywords. Studies involving adults with AP were analyzed to compare the outcomes of crystalloid and colloid use, aggressive vs. moderate fluid resuscitation, and administration timings. The primary outcomes were mortality and severe complications, while secondary outcomes included organ failure, SIRS, and length of hospital stay. <b>Results:</b> Crystalloids, particularly Ringer’s lactate (RL), are superior to normal saline in reducing SIRS, organ failure, and intensive care unit stays without significantly affecting mortality rates. Colloids were associated with adverse events such as renal impairment and coagulopathy, limiting their use. Aggressive fluid resuscitation increased the risk of fluid overload, respiratory failure, and acute kidney injury, particularly in severe AP, while moderate hydration protocols achieved comparable clinical outcomes with fewer complications. <b>Conclusions:</b> Moderate fluid resuscitation using RL is recommended for managing AP, balancing efficacy with safety. Further research is needed to establish optimal endpoints and protocols for fluid therapy, ensuring improved patient outcomes while minimizing complications. |
| format | Article |
| id | doaj-art-de1e8241da3548009ef755b392693bd7 |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-de1e8241da3548009ef755b392693bd72025-08-20T02:17:00ZengMDPI AGDiagnostics2075-44182025-03-0115781010.3390/diagnostics15070810Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic ReviewCristian-Nicolae Costea0Cristina Pojoga1Andrada Seicean2Departament of Gastroneterology, Iuliu Hațieganu University of Medicine and Pharmacy, Croitorilor Str., no 19-21, 400162 Cluj-Napoca, RomaniaRegional Institute of Gastroenterology and Hepatology, Croitorilor Str., no 19-21, 400162 Cluj-Napoca, RomaniaRegional Institute of Gastroenterology and Hepatology, Croitorilor Str., no 19-21, 400162 Cluj-Napoca, Romania<b>Background/Objectives:</b> Acute pancreatitis (AP) is an inflammatory condition with diverse origins, often resulting in significant morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiorgan failure. Fluid resuscitation is pivotal in early management, and it is aimed at preventing hypovolemia-induced ischemia and necrosis. This review evaluates fluid therapy strategies in AP, including fluid types, resuscitation rates, and clinical outcomes. <b>Methods:</b> This systematic review was conducted in January 2025 using databases such as PubMed, Medline, and Google Scholar, focusing on studies published between 2010 and 2024. Search terms included “acute pancreatitis”, “fluid resuscitation”, and related keywords. Studies involving adults with AP were analyzed to compare the outcomes of crystalloid and colloid use, aggressive vs. moderate fluid resuscitation, and administration timings. The primary outcomes were mortality and severe complications, while secondary outcomes included organ failure, SIRS, and length of hospital stay. <b>Results:</b> Crystalloids, particularly Ringer’s lactate (RL), are superior to normal saline in reducing SIRS, organ failure, and intensive care unit stays without significantly affecting mortality rates. Colloids were associated with adverse events such as renal impairment and coagulopathy, limiting their use. Aggressive fluid resuscitation increased the risk of fluid overload, respiratory failure, and acute kidney injury, particularly in severe AP, while moderate hydration protocols achieved comparable clinical outcomes with fewer complications. <b>Conclusions:</b> Moderate fluid resuscitation using RL is recommended for managing AP, balancing efficacy with safety. Further research is needed to establish optimal endpoints and protocols for fluid therapy, ensuring improved patient outcomes while minimizing complications.https://www.mdpi.com/2075-4418/15/7/810acute pancreatitisfluid resuscitationsystematic review |
| spellingShingle | Cristian-Nicolae Costea Cristina Pojoga Andrada Seicean Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review Diagnostics acute pancreatitis fluid resuscitation systematic review |
| title | Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review |
| title_full | Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review |
| title_fullStr | Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review |
| title_full_unstemmed | Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review |
| title_short | Advances in the Management of Fluid Resuscitation in Acute Pancreatitis: A Systematic Review |
| title_sort | advances in the management of fluid resuscitation in acute pancreatitis a systematic review |
| topic | acute pancreatitis fluid resuscitation systematic review |
| url | https://www.mdpi.com/2075-4418/15/7/810 |
| work_keys_str_mv | AT cristiannicolaecostea advancesinthemanagementoffluidresuscitationinacutepancreatitisasystematicreview AT cristinapojoga advancesinthemanagementoffluidresuscitationinacutepancreatitisasystematicreview AT andradaseicean advancesinthemanagementoffluidresuscitationinacutepancreatitisasystematicreview |