SynthesisCritical care (London, England)2023
Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- AEG-AESPANC-OPGE-SIED-SPG Ibero-Latin American Guidelines on Acute Pancreatitis (iLATAM-AP).United European gastroenterology journal · 2026Guideline
- Normal saline vs. lactated ringer's for fluid resuscitation in acute pancreatitis: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Correlation between early cumulative fluid balance and 90-day all-cause mortality in patients with acute pancreatitis: a retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Association of fluid balance trajectories and cumulative fluid balance with in-hospital mortality in patients with acute pancreatitis.Frontiers in medicine · 2026Article
- Early fluid therapy trajectories in acute pancreatitis: a retrospective cohort study.World journal of emergency surgery : WJES · 2025Article
- Fluid therapy strategies in acute pancreatitis: Randomized controlled trial comparing dextran and Ringer's lactate.World journal of gastrointestinal surgery · 2025Article
- 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
- Association of fluid balance index with in-hospital mortality in critically ill patients with acute pancreatitis: a multicenter retrospective cohort study.World journal of emergency medicine · 2025Article
- Machine Learning-Guided Fluid Resuscitation for Acute Pancreatitis Improves Outcomes.Clinical and translational gastroenterology · 2025Article
- Risk prediction of all-cause mortality in hospitalized patients with severe acute pancreatitis by serum urea nitrogen/albumin ratio.PloS one · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent practice guidelines for optimal infusion rates during early intravenous hydration in patients with acute pancreatitis (AP) remain inconsistent. This systematic review and meta-analysis aimed to compare treatment outcomes between aggressive and non-aggressive intravenous hydration in severe and non-severe AP.
methodsThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase and Cochrane Library for randomized controlled trials (RCTs) on November 23, 2022, and hand-searched the reference lists of included RCTs, relevant review articles and clinical guidelines. We included RCTs that compared clinical outcomes from aggressive and non-aggressive intravenous hydration in AP. Meta-analysis was performed using a random-effects model for participants with severe AP and non-severe AP. Our primary outcome was all-cause mortality, and several secondary outcomes included fluid-related complications, clinical improvement and APACHE II scores within 48 h.
resultsWe included a total of 9 RCTs with 953 participants. The meta-analysis indicated that, compared to non-aggressive intravenous hydration, aggressive intravenous hydration significantly increased mortality risk in severe AP (pooled RR: 2.45, 95% CI: 1.37, 4.40), while the result in non-severe AP was inconclusive (pooled RR: 2.26, 95% CI: 0.54, 9.44). However, aggressive intravenous hydration significantly increased fluid-related complication risk in both severe (pooled RR: 2.22, 95% CI 1.36, 3.63) and non-severe AP (pooled RR: 3.25, 95% CI: 1.53, 6.93). The meta-analysis indicated worse APACHE II scores (pooled mean difference: 3.31, 95% CI: 1.79, 4.84) in severe AP, and no increased likelihood of clinical improvement (pooled RR:1.20, 95% CI: 0.63, 2.29) in non-severe AP. Sensitivity analyses including only RCTs with goal-directed fluid therapy after initial fluid resuscitation therapy yielded consistent results.
conclusionsAggressive intravenous hydration increased the mortality risk in severe AP, and fluid-related complication risk in both severe and non-severe AP. More conservative intravenous fluid resuscitation protocols for AP are suggested.
Indexed as
Identifiers
What OpenQuestion holds
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.