Fluid resuscitation with lactated Ringer’s solution vs normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial

Abstract

Lactated Ringer's is associated with an anti-inflammatory effect in patients with acute pancreatitis.

Ringer's lactate versus normal saline in acute pancreatitis: A systematic review and meta‐analysis

“…revealed that Ringer's lactate was associated with the decreased persistence of SIRS, and similar results were shown in a study by Wu et al . which supports the anti‐inflammatory effects of Ringer's lactate . C‐reactive protein is a cost‐effective, widely used non‐specific inflammatory marker and various studies have shown it as a useful predictor of the severity of AP .…”

“…Most of these 19 studies were reports of a comparison between Ringer's lactate with normal saline in post‐ERCP pancreatitis. Finally, five studies including 428 participants met the eligibility criteria. Two of the included studies were retrospective observational cohort studies and three were RCTs.…”

“…Only three studies reported that the patients met the SIRS criteria on admission and at 24 h. In total, 23 patients in the Ringer's lactate group ( n = 61) and 28 in the normal saline group ( n = 66) were found to have SIRS on admission ( P = 0.58). After 24 h, only seven patients in the Ringer's lactate group met the criteria of SIRS, compared with 17 in the normal saline group.…”

“…hydration in these patients . Recent studies have shown that use of a more balanced solution, Ringer's lactate, can improve mortality rates and decrease the development of SIRS over 24–48 h in these patients, compared with normal saline . However, existing data are conflicting and are limited to small‐sized studies.…”

Practical guide to the management of acute pancreatitis

“…Goal-directed rehydration with Ringer’s lactate solution (or Hartmann’s) is recommended31 at a rate of 5–10 mL/kg/hour until resuscitation goals are reached 26. A recent triple-blind RCT compared Ringer’s lactate to normal saline in AP and found that Ringer’s lactate was associated with an anti-inflammatory effect which was attributed to the properties of lactate 32. A urinary catheter should be inserted in severe AP in order to record accurate fluid balance.…”