Comparison of normal saline versus Lactated Ringer's solution for fluid resuscitation in patients with mild acute pancreatitis,A randomized controlled trial

Background/Objectives

Aggressive fluid resuscitation is recommended for initial management of acute pancreatitis. However, there are few studies which focus on types of fluid therapy.

Methods

We performed a randomized controlled trial in patients with acute pancreatitis. The patients were randomized into two groups. Each group received Normal Saline solution (NSS) or Lactated Ringer's solution (LRS) through a goal-directed fluid resuscitation protocol. Systemic inflammatory response syndrome (SIRS) at 24 and 48?h, mortality, presence of local complications and inflammatory markers were measured.

Results

Forty-seven patients were included. Twenty-four patients (51%) received NSS and 23 patients received LRS. There was significant reduction in SIRS after 24?h among subjects who resuscitated with LRS compared with NSS (4.2% in NSS, 26.1% in LRS, P?=?0.02). However, SIRS reduction at 48?h was not different between groups (33.4% in NSS, 26.1% in LRS, P?=?0.88). Mortality was not different between NSS and LRS (4.2% in NSS, 0% in LRS, P?=?1.00). CRP, ESR and procalcitonin increased at 24?h and 48?h after admission with no difference between the two groups. Local complications were 29.2% in NSS and 21.7% in LRS (P?=?0.74). The median length of hospital stay was not significantly different in the two groups (5.5 days in NSS, 6 days in LRS, P?=?0.915).

Conclusions

Lactated Ringer's solution was superior to NSS in SIRS reduction in acute pancreatitis only in the first 24?h. But SIRS at 48?h and mortality were not different between LRS and NSS.