Efficacy and safety of early enteral and intravenous fluid resuscitation in severe acute pancreatitis: a systematic review and meta-analysis

Liu, Jiao; Qiu, Huifang; Yang, Yuan; Liu, Chengjiang; Mo, Shaojian; He, Fei; Fu, Xinping

doi:10.1007/s00384-023-04335-7

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…In particular, early uid resuscitation assumes a pivotal role within 24-48 h post onset [23]. Various investigations [24] indicate that uid resuscitation can also be carried out through enteral (nasoenteric and colorectal) means. This topic explores uid resuscitation through the traditional intravenous route.…”

Section: Degree Of Harmonization Of Expert Advicementioning

confidence: 99%

Construction of a nursing management program for early fluid resuscitation in patients with acute pancreatitis: A Delphi study in China

He,

Zhang,

Liu

et al. 2024

Preprint

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Aim and Objectives: To construct a set of scientific and feasible nursing management protocols for early fluid resuscitation in acute pancreatitis patients who can be used to guide clinical practice and enhance the treatment efficacy in these patients. Background Fluid resuscitation is a key means of early treatment for AP patients and has become a clinical consensus. Nurses are important practitioners of fluid resuscitation, and there is a lack of specific enforceable nursing management programs. Methods Through literature research, on-site research, semi-structured interviews, and other preliminary preparations of the first draft of the nursing management program for early fluid resuscitation in acute pancreatitis, the Delphi method was used to conduct two rounds of correspondence with medical and nursing experts, and then statistically analyzed. Results Fifteen and 14 questionnaires were distributed in two rounds, respectively, and 15 and 14 questionnaires were recovered, respectively. The positive coefficient of experts was 100%, the authority coefficient was 0.970 and 0.975, respectively; the importance assignment was x ± s; the coefficient of variation coefficient was 0.05–0.21 and 0.00–0.20, respectively; and Kendall’s harmony coefficient was 0.05, with a test level of α = 0.05. A total of 5 primary indicators, 11 secondary indicators, and 36 tertiary indicators were used to construct the Nursing Management Program for Early Fluid Resuscitation in Acute Pancreatitis. Conclusions The constructed nursing management plan for early fluid resuscitation in acute pancreatitis patients puts forward clear requirements and standards for nursing care in the early stage of AP treatment. This plan is in line with the principles of science and operability, has good clinical application and promotion value, and can promote standardized management of early fluid resuscitation in patients with acute pancreatitis.

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Section: Degree Of Harmonization Of Expert Advicementioning

confidence: 99%

Construction of a nursing management program for early fluid resuscitation in patients with acute pancreatitis: A Delphi study in China

He,

Zhang,

Liu

et al. 2024

Preprint

Self Cite

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“…There is data to support early enteral fluid resuscitation – Di Martino et al [11] found no significant difference in the rates of mortality, organ failure, or length of hospital stay between different types of fluids or rates of fluid administration but found that enteral (oral or tube feeding) fluids were safe and associated with a lower risk of infection and organ failure compared to intravenous fluids. Liu et al [12] in a meta-analysis of seven studies with 580 patients (291 with enteral fluids and 289 with intravenous fluids), similarly reported no statistically significant differences in mortality, surgical intervention, or the incidence of localized ascites with the enteral route, but the enteral resuscitation group had reduced new organ failure, persistent organ failure, and rates of mechanical ventilation and ICU admission.…”

Section: Introductionmentioning

confidence: 99%

“…Fluid resuscitation (FR) is a central component of supportive care in AP. Despite a multitude of publications including randomized controlled trials and metaanalyses on the topic, there are still many gaps in knowledge on the various aspects of FR [5 && , [6][7][8][9][10][11][12]. The purpose of this review is to critically evaluate the evidence from the literature to obtain the current perspective on FR in AP.…”

Section: Introductionmentioning

confidence: 99%

Fluid resuscitation in acute pancreatitis

Yang

Vege

2023

Current Opinion in Gastroenterology

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Purpose of review The purpose of the review is to critically evaluate the evidence from the literature to establish the current perspective on fluid resuscitation (FR) in acute pancreatitis (AP). We will review the rationale, type of fluid, rate of administration, total volume, duration, monitoring, ideal outcomes to be studied in clinical trials and recommendations for future studies. Recent findings FR remains the key component of supportive therapy in AP. The paradigm has shifted from administration of aggressive fluid resuscitation towards more moderate FR strategies. Lactated Ringer's remains the preferred fluid for resuscitation. There remain critical gaps in knowledge regarding the end point(s) to indicate adequate resuscitation, and accurate assessments of fluid sequestration and intravascular volume deficit in AP. Summary There is insufficient evidence to state that goal-directed therapy, using any of the parameters to guide fluid administration, reduces the risk of persistent organ failure, infected pancreatic necrosis, or mortality in AP, as well as the most appropriate method for the same.

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