Comparison of Clinical Outcomes between Aggressive and Non-Aggressive Intravenous Hydration for Pancreatitis

Shaheen, Youssry Abd Rabo; Aglan, Bassem Mefreh; Okab, Engy Ali; El Gouhary, Ahmed Sami

doi:10.21608/bjas.2024.311896.1472

Comparison of Clinical Outcomes between Aggressive and Non-Aggressive Intravenous Hydration for Pancreatitis

Document Type : Original Research Papers

Authors

¹ Professor of Cardiothoracic Faculty of Medicine-Benha University

² Assistant Professor of Cardiothoracic Faculty of Medicine Benha University

³ Lecturer of Critical Care Medicine Faculty of Medicine-Benha University

⁴ Department of critical care medicine Medicine Faculty of Medicine-Benha University

10.21608/bjas.2024.311896.1472

Abstract

Background: Among the most common and serious gastrointestinal illnesses that lead to hospitalizations globally, pancreatitis (AP) ranks high. There have been reports of an increase in the incidence of pancreatitis, which has an estimated worldwide incidence of 34 cases per 100,000 person-years and a fatality rate of 1.6 fatalities per 100,000 person-years. Making the right choices when managing AP in the beginning may have a major impact on how the illness progresses and how long the patient has to stay in the hospital. To avoid hypovolemia and organ hypoperfusion, fluid resuscitation using mostly isotonic crystalloid (i.e., normal saline or Ringer's lactate solution) should be started early in the course of pneumonia (AP) therapy, as per many worldwide standards. This should be done before hemodynamic deterioration has occurred. Nevertheless, there is still no consensus among the standards for the infusion rate in the design of fluid resuscitation regimens. For instance, unless there are cardiovascular and/or renal comorbidities, all patients with AP should get intensive intravenous hydration (250-500 ml/hour) during the first 12-24 hours, according to the American College of Gastroenterology (ACG) recommendations. Objective: Read this review article to find out how aggressive intravenous hydration compared to non-aggressive treatment for pancreatitis. In summary. Essential life support measures include oxygen, nourishment, intravenous fluid resuscitation, and pain medication. Discontinuation of nil-by-mouth gastric restraint, regular prophylactic antimicrobial administration, and early opiate analgesia avoidance have all been debunked in randomized studies and are not recommended in international standards.

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