Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis
ABSTRACT Background A conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare...
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Wiley
2024-12-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70073 |
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| author | Muhammad Ehsan Aamna Badar Ahmad Haseeba Javed Afra Zahid Hafiz Sheheryar Aamir Huzaifa Ahmad Cheema Muhammad Ayyan Biah Mustafa Abia Shahid Muhammad Abdullah Ilyas Kamal Kandel Rehmat Ullah Awan Sana Iqbal |
| author_facet | Muhammad Ehsan Aamna Badar Ahmad Haseeba Javed Afra Zahid Hafiz Sheheryar Aamir Huzaifa Ahmad Cheema Muhammad Ayyan Biah Mustafa Abia Shahid Muhammad Abdullah Ilyas Kamal Kandel Rehmat Ullah Awan Sana Iqbal |
| author_sort | Muhammad Ehsan |
| collection | DOAJ |
| description | ABSTRACT Background A conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare outcomes between the two resuscitation strategies in our meta‐analysis. Methods We searched MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov for all available randomized controlled trials (RCTs) assessing outcomes for patients treated with aggressive fluid replacement compared to moderate fluid replacement. Our primary outcome was all‐cause mortality. Results Our meta‐analysis included 6 RCTs involving a total of 632 patients. Our results showed that aggressive fluid resuscitation increased the risk of all‐cause mortality as compared to moderate fluid replacement (RR 2.40, CI: 1.38–4.19). For all of our secondary outcomes which included the development of organ failure, severe pancreatitis, pancreatic necrosis, clinical improvement, development of SIRS, persistent SIRS, and length of hospital stay, the results indicate that there was no significant difference between the two groups. Conclusions Aggressive fluid resuscitation is associated with higher mortality as compared to moderate fluid replacement in patients with acute pancreatitis. RCTs with larger sample sizes are needed to provide greater statistical power and establish more definitive conclusions. |
| format | Article |
| id | doaj-art-9113a2f3fb254e5f9b4b3915a3d891fe |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-9113a2f3fb254e5f9b4b3915a3d891fe2024-12-30T04:16:37ZengWileyJGH Open2397-90702024-12-01812n/an/a10.1002/jgh3.70073Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐AnalysisMuhammad Ehsan0Aamna Badar Ahmad1Haseeba Javed2Afra Zahid3Hafiz Sheheryar Aamir4Huzaifa Ahmad Cheema5Muhammad Ayyan6Biah Mustafa7Abia Shahid8Muhammad Abdullah Ilyas9Kamal Kandel10Rehmat Ullah Awan11Sana Iqbal12Department of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine King Edward Medical University Lahore PakistanDepartment of Medicine Kathmandu University Dhulikhel NepalDepartment of Internal Medicine Ochsner Health Center New Orleans Louisiana USADepartment of Internal Medicine DMC Sinai Grace Hospital Detroit Michigan USAABSTRACT Background A conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare outcomes between the two resuscitation strategies in our meta‐analysis. Methods We searched MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov for all available randomized controlled trials (RCTs) assessing outcomes for patients treated with aggressive fluid replacement compared to moderate fluid replacement. Our primary outcome was all‐cause mortality. Results Our meta‐analysis included 6 RCTs involving a total of 632 patients. Our results showed that aggressive fluid resuscitation increased the risk of all‐cause mortality as compared to moderate fluid replacement (RR 2.40, CI: 1.38–4.19). For all of our secondary outcomes which included the development of organ failure, severe pancreatitis, pancreatic necrosis, clinical improvement, development of SIRS, persistent SIRS, and length of hospital stay, the results indicate that there was no significant difference between the two groups. Conclusions Aggressive fluid resuscitation is associated with higher mortality as compared to moderate fluid replacement in patients with acute pancreatitis. RCTs with larger sample sizes are needed to provide greater statistical power and establish more definitive conclusions.https://doi.org/10.1002/jgh3.70073acute pancreatitisfluid replacementfluid resuscitationmeta‐analysis |
| spellingShingle | Muhammad Ehsan Aamna Badar Ahmad Haseeba Javed Afra Zahid Hafiz Sheheryar Aamir Huzaifa Ahmad Cheema Muhammad Ayyan Biah Mustafa Abia Shahid Muhammad Abdullah Ilyas Kamal Kandel Rehmat Ullah Awan Sana Iqbal Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis JGH Open acute pancreatitis fluid replacement fluid resuscitation meta‐analysis |
| title | Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis |
| title_full | Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis |
| title_fullStr | Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis |
| title_short | Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis |
| title_sort | aggressive versus moderate fluid replacement for acute pancreatitis an updated systematic review and meta analysis |
| topic | acute pancreatitis fluid replacement fluid resuscitation meta‐analysis |
| url | https://doi.org/10.1002/jgh3.70073 |
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