Effects of Fluid Resuscitation on the Occurrence of Organ Failure and Mortality in Patients With Acute Pancreatitis

Abstract

Objectives Acute pancreatitis (AP) is a serious gastroenterological condition requiring urgent fluid resuscitation and emergent intensive care. However, the benefit of fluid resuscitation is inconsistent. Therefore, this study aimed to examine the effects of fluid resuscitation on the occurrence of organ failure and mortality in patients with AP. Methods The data were retrospectively extracted from the Medical Information Mart for Intensive Care III 2002–2012 database. The fluid resuscitation and fluid balance were calculated at 12, 24, 36, and 48 hours after intensive care unit admission. Multivariate analysis models were used. Results A total of 317 patients with AP were included. Odds of organ failure increased significantly with increased fluid input at 0 to 12 hours [adjusted odds ratio (aOR), 1.124; 95% confidence interval (CI), 1.015–1.244] and with increased fluid balance at 36 to 48 hours (aOR, 1.184; 95% CI, 1.009–1.389). Odds of in-hospital mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.201; 95% CI, 1.052–1.371). Odds of 30-day mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.189; 95% CI, 1.039–1.361). Conclusions Increased fluid balance was associated with increased risk of organ failure and mortality. Increased fluid output may decrease mortality.

The burden of acute pancreatitis on COVID-19 in the United States

“…There was a 98% higher likelihood of ICU admissions in patients with concomitant AP and COVID-19, which can be explained by higher rates of sepsis, AKI, and shock. Furthermore, aggressive early fluid resuscitation is essential in the management of AP [ 35 , 36 ]. Cautious use of intravenous fluids in patients with COVID-19, due to concern for worsening of respiratory status, might have led to under-resuscitation and worse outcomes.…”