Efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in early treatment of acute pancreatitis： A Meta－analysis

Zhangpeng WANG; Guangxu JING; Huanhuan LUO; Hongfei DONG; Xuyang WANG; Hongyu SUN; Lijun TANG

doi:10.3969/j.issn.1001-5256.2023.09.019

Volume 39 Issue 9

Sep. 2023

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Article Navigation > Journal of Clinical Hepatology > 2023 > 39(9): 2158-2168

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Efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in early treatment of acute pancreatitis： A Meta－analysis

DOI: 10.3969/j.issn.1001-5256.2023.09.019

Zhangpeng WANG^{1a, 2},
Guangxu JING^{1a, 2},
Huanhuan LUO^{1a, 3},
Hongfei DONG^1a,
Xuyang WANG^{1a, 4},
Hongyu SUN^{1a, 1b},
Lijun TANG^{1a, 2
,
,
,}

1a.
PLA Center of General Surgery/Key Laboratory of Pancreatic Injury and Repair of Sichuan Province，The General Hospital of Western Theater Command，Chengdu 610083，China
1b.
Basic Medical Laboratory，The General Hospital of Western Theater Command，Chengdu 610083，China
2.
College of Medicine，Southwest Medical University，Luzhou，Sichuan 646000，China
3.
College of Medicine，Southwest Jiaotong University，Chengdu 610063，China
4.
College of Medicine，Chongqing Medical University，Chongqing 400016，China

Research funding:

National Natural Science Foundation of China (81772001);

National Clinical Key Subject of China (41732113);

Science and Technology Foundation of Sichuan Province (2019YJ0277)

More Information

Corresponding author: TANG Lijun， tanglj2016@163.com （ORCID： 0000－0001－6000－9515）
Received Date: 2022-12-04
Accepted Date: 2022-12-31
Published Date: 2023-09-19

Abstract

Abstract

Objective To systematically evaluate the efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in the early treatment of acute pancreatitis （AP）， and to provide a reference for clinical research and practice. Methods This study was conducted according to PRISMA guidelines， with a PROSPERO registration number of CRD42023455046. Chinese and English databases such as PubMed， the Cochrane Library， Web of Science， CNKI， VIP， and Wanfang Data were searched for randomized controlled trials and cohort studies on the clinical efficacy of aggressive fluid resuscitation versus conventional fluid resuscitation in the treatment of AP published up to November 30， 2022. RevMan 5.4 and Stata 17.0 were used to perform the meta－analysis. Results A total of 15 studies were included， with 4 061 patients in total. The meta－analysis showed that compared with the conventional fluid resuscitation group， the aggressive fluid resuscitation group had significantly higher incidence rate of persistent organ failure （odds ratio ［OR］=2.19， 95% confidence interval ［CI］： 1.46－3.29， P<0.001）， incidence rate of pancreatic necrosis （OR=1.73， 95%CI： 1.19－2.51， P=0.004）， and mortality rate （OR=1.64， 95%CI： 1.26－2.14， P<0.001）， as well as significantly higher risks of infectious pancreatic necrosis （OR=1.82， 95%CI： 1.33－2.48， P<0.001）， circulatory failure （OR=6.31， 95%CI： 1.81－21.93， P=0.004）， respiratory failure （OR=3.81， 95%CI： 1.77－8.19， P<0.001）， renal failure （OR=1.88， 95%CI： 1.11－3.19， P=0.02）， abdominal compartment syndrome （OR=6.01， 95%CI： 2.45－14.71， P<0.001）， and fluid overload （OR=3.83， 95%CI： 1.65－8.88， P=0.002）. Conclusion Aggressive fluid resuscitation shows poor efficacy and safety in the early treatment of AP and may be unfavorable to the prognosis of patients. Due to the limited quantity and quality of studies included， more large multicenter randomized controlled trials are needed for verification in the future.
- Pancreatitis,
- Fluid Resuscitation,
- Treatment Outcome,
- Meta－Analysis

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References(44)

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Efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in early treatment of acute pancreatitis： A Meta－analysis

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Efficacy and safety of aggressive fluid resuscitation versus conventional fluid resuscitation in early treatment of acute pancreatitis： A Meta－analysis

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