Fluid Choice Matters in Critically-ill Patients with Acute Pancreatitis: Lactated Ringer's vs. Isotonic Saline.

OBJECTIVES: To investigate the effect of different crystal- loid solutions on clinical outcomes in critically-ill patients with acute pancreatitis (AP).

METHODS: We conducted a retrospective study of patients with AP admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. We investigated the effect of fluid type; lactated ringer's (LR) vs. isotonic saline (IS) on hospital mortality rates, and ICU length of stay (LOS).

RESULTS: Hospital mortality of the 198 included patients was 12%. For fluid type, 32.9% were resuscitated with LR vs. 67.1% with IS. Hospital mortality was lower in the LR group (5.8%) vs. 14.9% for IS group, odds ratio of 3.10 [P=0.041]. This effect was still observed after adjusting for confounders. However, ICU LOS was longer in LR compared to IS group; 6.2±6.9 vs. 4.2±4.49 days respectively [P= 0.020].

CONCLUSION: The type of fluid used for resuscitation in AP may affect the outcome. LR may have survival benefit over IS in critically-ill patients with AP. [Full article available at https://rimed.org/rimedicaljournal-2016-10.asp].