医学
荟萃分析
急性胰腺炎
内科学
科克伦图书馆
随机对照试验
重症监护医学
胰腺炎
系统回顾
梅德林
作者
Marcello Di Martino,Stijn Van Laarhoven,Benedetto Ielpo,J.M. Ramia,Alba Manuel-Vázquez,Aleix Martínez-Pérez,Mihai Pavel,Pablo Beltran Miranda,Rafael Orti-Rodríguez,Sofía de la Serna,Guillermo Ortega Rabbione,Ancor Sanz-García,Elena Martín-Pérez
出处
期刊:Hpb
[Elsevier]
日期:2021-07-08
卷期号:23 (11): 1629-1638
标识
DOI:10.1016/j.hpb.2021.06.426
摘要
Abstract Background Adequate fluid resuscitation is paramount in the management of acute pancreatitis (AP). The aim of this study is to assess benefits and harms of fluid therapy protocols in patients with AP. Methods MEDLINE, Embase, Science Citation Index and clinical trial registries were searched for randomised clinical trials published before May 2020, assessing types of fluids, routes and rates of administration. Results A total 15 trials (1073 participants) were included. Age ranged from 38 to 73 years; follow-up period ranged from 0.5 to 6 months. Ringer lactate (RL) showed a reduced number of severe adverse events (SAE) when compared to normal saline (NS) (OR 0.48; 95%CI 0.29–0.81, p = 0.006); additionally, NS showed reduced SAE (RR 0.38; 95%IC 0.27–0.54, p High fluid rate fluid infusion showed increased mortality (OR 2.88; 95%CI 1.41–5.88, p = 0.004), increased number of SAE (RR 1.42; 95%CI 1.04–1.93, p = 0.030) and higher incidence of sepsis (RR 2.80; 95%CI 1.51–5.19, p = 0.001) compared to moderate fluid rate infusion. Conclusions In patients with AP, RL should be preferred over NS and HES should not be recommended. Based on low-certainty evidence, moderate-rate fluid infusion should be preferred over high-rate infusion.
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