Model for Severity Prediction in Pediatric Acute Pancreatitis

Duran, Fatih; Dereci, Selim; Aksu, Aysel Ünlüsoy; Demir, Arzu Meltem; Ateş, Burcu Bereberoğlu; Hızal, Gülin; Hızlı, Şamil

doi:10.1097/mpg.0000000000003224

Cited by 1 publication

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“…However, this had never been investigated prospectively in the pediatric AP population until now. In fact there remains significant room for improvement and research into optimal treatment for pediatric AP as well as in identifying patients at risk for progression to severe disease 15,16 …”

Section: Discussionmentioning

confidence: 99%

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Faster discharge with lactated ringers than normal saline in first 72 h of acute pancreatitis: A multicenter randomized trial

Farrell,

DesPain,

Farmer

et al. 2023

J. pediatr. gastroenterol. nutr.

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ObjectivesData driven strategies for acute pancreatitis (AP) in pediatrics are limited; adult data suggests lactated ringers (LR) compared to normal saline (NS) resulted in favorable outcomes, but has not been studied in pediatrics. Our objective was to evaluate the efficacy of LR during the first 48 h of an AP episode compared with NS.Study DesignA multisite randomized controlled clinical trial, from 2015 to 2020 (Clinical Trials.gov NCT03242473). Patients were randomized to exclusively LR or NS for the first 48 h. Primary outcomes were serial C‐reactive protein (CRP) values. Secondary outcomes included other lab values, time to feeds, length of stay (LOS), systemic inflammatory response syndrome (SIRS) development, and progression to severe AP (SAP).ResultsWe studied 76 patients (38 LR, 38 NS). CRP at 24 and 48 h were not significantly different between LR or NS group. Additionally, there were no differences in trends of BUN, amylase, lipase, SIRS status, or SAP development between the LR and NS group at 24 and 48 h. A higher proportion of LR patients (32%, 12/38) were discharged before 48 h compared to NS (13%, 5/38). The LR group had a significantly higher rate of discharge within the first 72 h compared to the NS group (p = 0.02).ConclusionThe use of LR was associated with a faster rate of discharge during the intervention period and in the first 72 h, but no other differences compared to NS. This reduction in length of hospitalization has significant implications for patients and healthcare costs.

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Section: Discussionmentioning

confidence: 99%

“…treatment for pediatric AP as well as in identifying patients at risk for progression to severe disease. 15,16 The mechanism of how LR may be more beneficial is not clear. Previous studies have suggested that LR may reduce the occurrence of hypochloremia, decrease activation of macrophages, or lead to a reduction in acidosis.…”

Section: Discussionmentioning

confidence: 99%