Abstract
BACKGROUND
Fluid resuscitation is one of the most important measures in the treatment of acute pancreatitis, and normal saline and lactated Ringer's solution are commonly used in clinic. Normal saline is cheap and easy to store, and has wide application. Lactated Ringer's solution is more like extracellular fluid, which can effectively replenish the body's water and electrolytes, reduce body damage, and reduce kidney replacement therapy. In recent years, a number of studies have found that the advantages of using lactated Ringer's solution or normal saline for fluid resuscitation are still controversial.
AIM
To compare the therapeutic efficacy of lactated Ringer's solution and normal saline for the management of acute pancreatitis.
METHODS
The databases of Weipu, CNKI, Wanfang, Web of Science, and PubMed were searched by computer, and the search time was up to December 2020. After data extraction, RevMan 5.4 software was used for statistical analyses.
RESULTS
A total of five studies were included, including 162 cases who used lactated Ringer's solution and 189 cases who used normal saline. Meta-analysis showed that compared with the normal saline group, the lactated Ringer's solution group had a lower ICU admission rate (odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.13-0.81, P = 0.02); however, there was no significant difference in length of stay (mean difference [MD] = -0.59, 95%CI: -1.26-0.08, P = 0.08), mortality (OR = 1.39, 95%CI: 0.44-4.40, P = 0.57), systemic inflammatory response syndrome at 24 h (OR = 0.73, 95%CI: 0.41-2.33, P = 0.28), or pancreatic necrosis (OR = 0.71, 95%CI: 0.35-1.45, P = 0.35) between the two groups.
CONCLUSION
Liquid resuscitation with lactated Ringer's solution can reduce ICU admission rate for patients with acute pancreatitis compared with normal saline. However, there are no significant differences in length of stay, mortality, systemic inflammatory response syndrome at 24 h, or pancreatic necrosis after treatment with lactated Ringer's solution compared with normal saline.
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