IVF in acute pancreatitis

Q: Which fluid is preferred in acute pancreatitis?

A) Lactated Ringer’s (LR)

B) normal saline (NS)

Answer: A

In the early phase of acute pancreatitis, the use of lactated Ringer’s has been found to reduce the length of stay and the risk of ICU admissions. And systemic inflammatory response syndrome (SIRS).

The only exception is that LR should be avoided in acute pancreatitis due to hypercalcemia as it contains 3 mEq/L calcium. 

#GI

References:

1. Aziz M, Ahmed Z, Weissman S, et al. Lactated Ringer's vs normal saline for acute pancreatitis: An updated systematic review and meta-analysis. Pancreatology 2021; 21:1217.

2. Wu BU, Hwang JQ, Gardner TH, et al. Lactated Ringer's solution reduces systemic inflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepatol 2011; 9:710.

3. de-Madaria E, Herrera-Marante I, González-Camacho V, et al. Fluid resuscitation with lactated Ringer's solution vs normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial. United European Gastroenterol J 2018; 6:63.

4. Choosakul S, Harinwan K, Chirapongsathorn S, et al. Comparison of normal saline versus Lactated Ringer's solution for fluid resuscitation in patients with mild acute pancreatitis, A randomized controlled trial. Pancreatology 2018; 18:507.

5. Lee A, Ko C, Buitrago C, et al. Lactated Ringers vs Normal Saline Resuscitation for Mild Acute Pancreatitis: A Randomized Trial. Gastroenterology 2021; 160:955.

6. Zhao G, Zhang JG, Wu HS, et al. Effects of different resuscitation fluid on severe acute pancreatitis. World J Gastroenterol 2013; 19:2044.