Complications of fluidotherapy in patients with acute pancreatitis: A contribution

Abstract

Introduction: Aggressive fluid therapy is frequently suggested in the treatment of acute pancreatitis. However, there is some controversy about the effect of this therapy concerning the development of clinical complications and the need for surgery. Objectives: To explore the relationship between fluid administration in the first 48 hours and the development of local or systemic complications, to contribute to clarifying some open questions on this subject. Methods: This study is based on records of 109 patients admitted to the Surgical High Dependency Unit of Tondela Viseu Hospital Centre, between 2007 and 2012, with the diagnosis of acute pancreatitis. Data were explored, and statistical tests were used to identify variables that differentiate patients with complications. Receiver operating characteristic (ROC) curves allowed to relate the amount of fluids at 48 hours with the occurrence of each complication. Logistic regression models were used to identify independent risk factors for each complication. Results: There was no significant relationship between fluid therapy at 48 hours with death nor with the occurrence of systemic complications. As opposed, fluid therapy at 48 hours revealed to be associated with local and late complications, presence of infection and need for surgery. Conclusion: High levels of fluid therapy in the first 48 hours were associated with the development of complications.

Keywords

• Acute pancreatitis
• Fluidotherapy
• Complications
• ROC curves
• Logistic regression