Lactated Ringers Does Not Reduce SIRS in Acute Pancreatitis Compared to Normal Saline: An Updated Meta-Analysis

Background We aimed to compare outcomes according to a Lactated Ringers (LR) versus Normal Saline (NS)-based strategy for acute pancreatitis. Methods A database search through November 2020 was done to identify studies comparing LR to NS for fluid rehydration in AP. The primary endpoint was systemic...

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Bibliographic Details
Published in:Digestive diseases and sciences 2022-07, Vol.67 (7), p.3265-3274
Main Authors: Vedantam, Shyam, Tehami, Nadeem, de-Madaria, Enrique, Barkin, Jodie A., Amin, Sunil
Format: Article
Language:English
Subjects:
Bias
Biochemistry
Comparative analysis
Confidence intervals
Database searching
Disease
Gastroenterology
Health aspects
Hepatology
Inflammation
Internet/Web search services
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Meta-analysis
Mortality
Oncology
Online searching
Original Article
Pancreatitis
Statistical analysis
Transplant Surgery
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Summary:Background We aimed to compare outcomes according to a Lactated Ringers (LR) versus Normal Saline (NS)-based strategy for acute pancreatitis. Methods A database search through November 2020 was done to identify studies comparing LR to NS for fluid rehydration in AP. The primary endpoint was systemic inflammatory response syndrome (SIRS) at 24 h. Mantel–Haenszel pooled odds ratios (OR) and 95% confidence intervals were constructed using a random effects model. Heterogeneity was assessed using the I 2 statistic. Publication bias was assessed using funnel plots. Results Six studies were included totaling 549 patients. No difference in the odds of developing SIRS was noted at 24 h (pooled OR 0.59, 95% CI 0.22–1.62, P  = 0.31) between LR and NS. I 2 indices showed low heterogeneity between the groups, and a funnel plot showed no obvious publication bias. There was no difference between LR and NS found for SIRS at 48 and 72 h, mortality, and other secondary outcomes. LR was associated with a decreased need for ICU admission. Conclusions This updated meta-analysis does not support the previously published finding that the use of LR (rather than NS) leads to a statistically significant decreased odds of SIRS in acute pancreatitis.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-021-07153-5