ReviewBiomedicines2023
Lactated Ringer's Solution Reduces Severity, Mortality, Systemic and Local Complications in Acute Pancreatitis: A Systematic Review and Meta-Analysis.
Review in Biomedicines, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- AEG-AESPANC-OPGE-SIED-SPG Ibero-Latin American Guidelines on Acute Pancreatitis (iLATAM-AP).United European gastroenterology journal · 2026Guideline
- Lactated Ringer's solution versus saline fluid resuscitation for reducing progression to moderate-to-severe acute pancreatitis: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Pooled it
- Evaluating the efficacy of different volume resuscitation strategies in acute pancreatitis patients: a systematic review and meta-analysis.BMC gastroenterology · 2024Pooled it
- Comparison of Fluid Resuscitation with Lactate Ringer's Versus Normal Saline in Acute Pancreatitis: An Updated Meta-Analysis.Digestive diseases and sciences · 2024Pooled it
- Review
- Association of early crystalloid type with mortality and costs in acute pancreatitis: a nationwide cohort study.Journal of gastroenterology · 2026Article
- Which fluid resuscitation strategy is associated with shorter length of stay in mild acute pancreatitis? Interaction between crystalloid type and administration rate.BMC gastroenterology · 2026Article
- Severe adverse clinical impacts are predicted by an early high positive fluid balance in patients with severe acute pancreatitis.Scientific reports · 2026Article
- Fluid Therapy in Acute Pancreatitis-Current Knowledge and Future Perspectives.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Fluid Resuscitation with Lactated Ringer vs. Normal Saline in Acute Pancreatitis: A Systematic Review and Meta-Analysis of Clinical Trials.Diseases (Basel, Switzerland) · 2025Review
- Acute Necrotizing Pancreatitis-Advances and Challenges in Management for Optimal Clinical Outcomes.Medicina (Kaunas, Lithuania) · 2025Review
- Article
- The 12-Year Experience of the Hungarian Pancreatic Study Group.Journal of clinical medicine · 2025Review
- Fluid Resuscitation Choice and its Effect on Plasma Chloride and Acute Kidney Injury in Severe Acute Pancreatitis: A Randomized Study of Normal Saline vs. Balanced Crystalloids (Physiomax).Journal of community hospital internal medicine perspectives · 2025Article
- Normal saline versus Ringer's solution and critical-illness mortality in acute pancreatitis: a nationwide inpatient database study.Journal of intensive care · 2024Article
- Women's Special Issue Series: Biomedicines.Biomedicines · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
Fluid therapy is the cornerstone of early supportive therapy in acute pancreatitis (AP). Regrettably, the type of fluid is still debated among clinicians, despite recent evidence from randomized controlled trials (RCTs). We aimed to incorporate all evidence from RCTs comparing lactated Ringer's solution (LR) with normal saline (NS) in adult and pediatric AP patients, with particular emphasis on clinically relevant outcomes. We evaluated RCTs comparing intravenous fluid resuscitation with LR to NS in adult or pediatric AP patients according to a prospectively registered protocol (CRD42021224542). Moderate-to-severe AP (MSAP), mortality, length of hospitalization (LoH), need for intensive care, the incidence of systemic (organ failure, OF) and local complications (in total), necrosis and pseudocyst formation were analyzed separately. Risk ratio (RR) and median difference (MD) were calculated with 95% confidence intervals (CI) using a random effect model. Risk of bias and quality of evidence were assessed. Altogether, 8 eligible RCTs were found, including 557 patients (LR: 278; NS: 279). LR reduced the risk of MSAP by 31% (RR: 0.59, 95% CI: 0.36-0.97, high quality) and the risk of death by 62% (RR: 0.48; 95% CI: 0.24-0.98, very low quality). LR was associated with a significantly lower risk of need for intensive care (RR: 0.50, 95% CI: 0.33-0.77), OF (RR: 0.78, 95% CI: 0.61-0.99) and local complications (RR: 0.64, 95% CI: 0.46-0.89). No significant risk reduction was observed for LoH (MD: -0.57 days, CI: -1.33-0.19), necrosis, pseudocyst and inflammatory parameters by LR compared to NS. LR reduces severity, mortality, need of intensive care and systemic and local complications in AP.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.