Fluid therapy strategies in acute pancreatitis: Randomized controlled trial comparing dextran and Ringer’s lactate

Table 1 Baseline characteristics of patients, mean ± SD/n (%)/median (interquartile range)

Type of solution	Intervention group, n = 55	Control group, n = 53	P value
Age in years	50.7 ± 13.2	51.9 ± 13.6	0.6
Male sex	42 (76.36)	41 (77.36)	1.0
Etiology			0.4
Alcohol	30 (54.55)	28 (52.83)
Gallstone	8 (14.55)	10 (18.87)
Metabolic	14 (25.45)	10 (18.87)
Others	3 (5.45)	5 (9.43)
Previous diabetes	7 (12.73)	8 (15.09)	0.9
History of smoking	25 (45.45)	18 (33.96)	0.3
Hematocrit as %	39.6 ± 6.0	39.6 ± 4.8	0.9
BUN in mg/dL	18 (13-25)	16 (12-21)	0.1
Serum creatinine in mg/dL	0.77 (0.60-0.90)	0.70 (0.58-0.89)	0.1
Albumin in g/dL	3.60 (3.34-4.00)	3.65 (3.50-4.10)	0.4
CTSI at 72 hours	3 (2-3)	3 (2-4)	0.2
BISAP score > 2	1 (0-1)	1 (0-1)	0.2
Marshal score	1 (0-1)	1 (0-1)	0.2
SOFA score	1 (1-3)	1 (1-3)	0.5
Severity of acute pancreatitis			0.7
Mild	12 (21.80)	14 (26.40)
Moderate	43 (78.20)	39 (73.60)
Volume of fluid resuscitation			0.4
At 24 hours	2500 (2000-2500)	2000 (2000-2500)
At 48 hours	4500 (4000-5000)	4000 (4000-4500)
At 72 hours	6500 (6000-7000)	6500 (6000-6500)
Total hospitalization costs (Euro)	1050 (853-1395)	1064 (885-1516)	0.2

BUN: Blood urea nitrogen; CTSI: Computed tomography severity index; BISAP: Bedside Index of Severity in Acute Pancreatitis; SOFA: Sequential Organ Failure Assessment.

Table 2 Fluid administration response at 72 hours, n (%)

Type of solution	Intervention group, n = 55	Control group, n = 53	P value
Fluid responsive	49 (89.10)	42 (79.20)	0.2
Fluid refractory	4 (7.30)	6 (11.30)	0.6
Fluid overload	2 (3.60)	5 (9.40)	0.4

Table 3 Effect of fluid resuscitation on inflammation, n (%)/median (interquartile range)

Parameter	Intervention group, n = 55	Control group, n = 53	P value
CRP in mg/L
At admission	23.0 (11.8-62.0)	27.0 (9.2-59.0)	0.7
At 24 hours	97.0 (30.5-149.0)	75.0 (35.0-153.0)	0.7
At 48 hours	80.0 (43.5-266.0)	176.0 (73.0-295.0)	0.06
At 72 hours	43.0 (20.0-104.5)	171.0 (66.0-300.0)	< 0.001
SIRS ≥ 2 criteria
At admission	47 (83.93)	41 (77.36)	0.2
At 24 hours	29 (51.79)	33 (62.26)	0.3
At 48 hours	14 (25.00)	18 (33.96)	0.3
At 72 hours	2 (3.57)	11 (20.75)	0.008
PCT in ng/mL
At admission	0.1 (0.0-0.1)	0.1 (0.0-0.5)	0.05
At 72 hours	0.1 (0.0-0.2)	0.2 (0.0-0.3)	0.06

CRP: C-reactive protein; SIRS: Systemic inflammatory response syndrome; PCT: Procalcitonin.

Table 4 Effect of fluid resuscitation on organ failure and clinical outcomes, mean ± SD/n (%)/median (interquartile range)

Parameter	Intervention group A, n = 55	Control group, n = 53	P value
Local complications at 3 months	11 (20.00)	15 (28.30)	0.4
Pancreatic necrosis at 3 months	4 (7.27)	5 (9.43)	0.7
Pseudocysts at 3 months	7 (12.73)	10 (18.87)	0.5
Infected local complications	5 (9.09)	7 (13.21)	0.7
Organ failure at 72 hours	2 (3.64)	7 (12.20)	NA
OF respiratory (PaO2/FiO2 < 300) at 72 hours	1 (1.82)	5 (9.43)	NA
OF creatinine (> 1.9 mg/dL) at 72 hours	0 (0)	0 (0)	NA
OF cardiovascular at 72 hours	1 (1.82)	2 (3.77)	NA
Total hospital stays in days	5 (4-7)	6 (5-7)	0.1
ICU stay in days	0.0 ± 0.0	0.0 ± 0.2
OF at 3 months	1 (1.82)1	2 (3.77)1	NA
30-day mortality rate	0 (0)	1 (1.89)	NA
3-month mortality rate	1 (1.82)	1 (1.89)	NA

¹Includes patients who died as the cause of death was attributed to organ failure.

OF: Organ failure; ICU: Intensive care unit; NA: Not available.