Early Predictors of Fluid Sequestration in Acute Pancreatitis

Abstract

Our study validated 4 of 5 predictors of increased FS⁴⁸ from the previous study. Presence of 4 predictors or more and increased FS⁴⁸ are both associated with persistent SIRS and POF.

The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis

“…Patients who required fluid therapy partily depended on the status of FS and higher FS in patients may result in hostile fluid therapy. There are very few studies of FS in respect of AP, and mainly focused on the factors associated with level of FS and effects on outcome 8 , 11 . These studies indicated that a younger age, alcoholic etiology, presence of systemic inflammatory response syndrome (SIRS), higher hematocrit levels and hyperglycemia were risk factors of developing FS at 48 hours after hospital admission.…”

“…These studies indicated that a younger age, alcoholic etiology, presence of systemic inflammatory response syndrome (SIRS), higher hematocrit levels and hyperglycemia were risk factors of developing FS at 48 hours after hospital admission. These patients also have higher susceptibility to local and systemic complications and longer hospital stays 8 , 11 . The cut-off value of the FS to predict the severity of AP has not been previously evaluated.…”

“…A standard calculation method of fluid output were including the total volumes of vomitus, urine, and stool. An additional 500 ml was added to the output if patient had a temperature ≥37.8 °C per day 8 . we also did not calculate the insensible fluid losses based on body weight 29 ; Second, information on SAP outcome, such as mortality and organ failure were not available in our analyses; Third, the study came from one center and the samples of patients are relatively small suggesting restricted application of the results; In order to objectively evaluate the significance of these parameters, a multicenter prospective study with a larger patient cohort is needed.…”

“…Although current guidelines recommend early fluid therapy in order to prevent tissue hypoperfusion and avert hypoxia, there is no consensus on the optimal amount and rate of fluid resuscitation 6 – 8 ; the evidence on which it is based remains paltry and of poor quality. The need for a great amount of fluid during the initial 24 h was associated with adverse outcome; and caution should be attention with regard to volume therapy in patients with AP 7 , 9 , 10 .…”

Association of Total Fluid Intake and Output with Duration of Hospital Stay in Patients with Acute Pancreatitis

“…Recent studies have illustrated the importance of fluid resuscitation in AP with improved morbidity and mortality [ 9 – 11 ]. Urine output and total fluid balance are important clinical endpoints to monitor, with increased fluid sequestration associated with worse outcomes in AP [ 12 , 13 ]. The primary aim of this study was to evaluate the associations of fluid balance and strictly monitored fluid intake and output (total and specific types) at 24 and 48 hours of hospital admission with outcomes in AP.…”