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Table of Contents
Vol. 9, No. 6, 2009
Issue release date: April 2010
Section title: Original Paper
Pancreatology 2009;9:770–776
(DOI:10.1159/000210022)

Faster Rate of Initial Fluid Resuscitation in Severe Acute Pancreatitis Diminishes In-Hospital Mortality

Gardner T.B. · Vege S.S. · Chari S.T. · Petersen B.T. · Topazian M.D. · Clain J.E. · Pearson R.K. · Levy M.J. · Sarr M.G.
aMiles and Shirley Fiterman Center for Digestive Diseases, and bDepartment of General Surgery, Mayo Clinic Rochester, Rochester, Minn., and cSection of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, N.H., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/20/2008
Accepted: 3/3/2009
Published online: 1/21/2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 5

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN

Abstract

Background/Aims: We evaluated the impact of the initial intravenous fluid resuscitation rate within the first 24 h of presentation to the emergency room on important outcomes in severe acute pancreatitis. Methods: Patients presenting directly with a diagnosis of severe acute pancreatitis were identified retrospectively. Patients were divided into two groups – those who received ≧33% (‘early resuscitation’) and <33% (‘late resuscitation’) of their cumulative 72-hour intravenous fluid volume within the first 24 h of presentation. The primary clinical outcomes were in-hospital mortality, development of persistent organ failure, and duration of hospitalization. Results: 17 patients were identified in the ‘early resuscitation’ group and 28 in the ‘late resuscitation’ group and there were no baseline differences in clinical characteristics between groups. Patients in the ‘late resuscitation’ group experienced greater mortality than those in the ‘early resuscitation’ group (18 vs. 0%, p < 0.04) and demonstrated a trend toward greater rates of persistent organ failure (43 vs. 35%, p = 0.31). There was no difference in the total amount of fluid given during the first 72 h. Conclusions: Patients with severe acute pancreatitis who do not receive at least one third of their initial 72-hour cumulative intravenous fluid volume during the first 24 h are at risk for greater mortality than those who are initially resuscitated more aggressively.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/20/2008
Accepted: 3/3/2009
Published online: 1/21/2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 5

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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