Continuous Infusion of Fluid Hydration Over 24 Hours Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Issued Date
2022-08-01
Resource Type
ISSN
01632116
eISSN
15732568
Scopus ID
2-s2.0-85117126659
Pubmed ID
34655014
Journal Title
Digestive Diseases and Sciences
Volume
67
Issue
8
Start Page
4122
End Page
4130
Rights Holder(s)
SCOPUS
Bibliographic Citation
Digestive Diseases and Sciences Vol.67 No.8 (2022) , 4122-4130
Suggested Citation
Chang A., Pausawasdi N., Charatcharoenwitthaya P., Kaosombatwattana U., Sriprayoon T., Limsrivilai J., Prachayakul V., Leelakusolvong S. Continuous Infusion of Fluid Hydration Over 24 Hours Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Digestive Diseases and Sciences Vol.67 No.8 (2022) , 4122-4130. 4130. doi:10.1007/s10620-021-07256-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83667
Title
Continuous Infusion of Fluid Hydration Over 24 Hours Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Author's Affiliation
Other Contributor(s)
Abstract
Background: Aggressive intravenous fluid hydration, by administering 3500 mL of lactated Ringer’s solution (LRS) in 9 h with a peri-procedural bolus, reduces post-ERCP pancreatitis (PEP) incidence. A concern of this strategy is adverse events related to volume overload; however, the impact of fluid hydration over an extended period without a bolus on PEP is unknown. Aim: To assess the effect of continuous infusion of high-volume fluid at a constant rate over 24 h on PEP incidence and severity. Methods: Two-hundred patients were randomly assigned (1:1) to receive either 3600 mL of LRS in 24 h starting 2 h before the ERCP (high-volume group) or maintenance fluid hydration calculated by the Holliday-Segar method (control group). Results: The mean age of the patients was 50.6 ± 11.6 years. The predominant indications were choledocholithiasis (48%) and malignancies (32%). Patient demographics and PEP risk factors were similar in both groups. Patients in the high-volume group received significantly more fluid than the control group (3600 vs. 2413 ml, P < 0.001). PEP incidence was not different between the high-volume and the control group (14% vs. 15%; relative risk 0.93: 95% CI 0.48–1.83, P = 0.84). There were no differences in moderate to severe PEP (3% vs. 4%; relative risk 0.75: 95% CI, 0.17–3.27, P = 1.00). Subgroup analysis did not show a benefit in high-risk patients. Only one patient in the control group developed peripheral edema. Conclusions: An infusion of high-volume hydration over 24 h is not sufficient to provide optimal hydration for PEP prevention. Clinical Trial Registry Number: No. NCT 02821546.
