Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,...Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.展开更多
BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,miti...BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,mitigating hypovolemia-induced ischemia and systemic inflammatory response syndrome(SIRS).AIM To evaluate dextran 40+Ringer’s lactate solution(RLS)vs RLS alone for fluid therapy in mild to moderate AP.METHODS We conducted a single-center,single-blind,randomized controlled trial involving 108 patients with mild to moderate AP.Participants were randomized to receive either dextran 40+RLS(1:3 ratio)or RLS alone.All patients underwent standardized,goal-directed fluid therapy and were monitored for clinical response,inflammatory markers,and complications.The primary outcomes were reduction in C-reactive protein(CRP)and resolution of SIRS at 72 hours.Secondary outcomes included organ failure,intensive care unit admission,mortality,and length of hospital stay.RESULTS The dextran 40+RLS group demonstrated significantly lower CRP levels.No differences were observed in SIRS changes,fluid overload,refractory status mortality,local complications,or organ failure rates.Hospitalization tended to be shorter in the dextran 40+RLS group(5 days vs 6 days)although not to a statistically significant level(P=0.1).Adverse events were mild and comparable in both groups.CONCLUSION Dextran 40+RLS improved the early CRP response in patients with AP without added complications.Although medium-term outcomes were similar,early benefits support its use in initial management.展开更多
文摘Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.
文摘BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,mitigating hypovolemia-induced ischemia and systemic inflammatory response syndrome(SIRS).AIM To evaluate dextran 40+Ringer’s lactate solution(RLS)vs RLS alone for fluid therapy in mild to moderate AP.METHODS We conducted a single-center,single-blind,randomized controlled trial involving 108 patients with mild to moderate AP.Participants were randomized to receive either dextran 40+RLS(1:3 ratio)or RLS alone.All patients underwent standardized,goal-directed fluid therapy and were monitored for clinical response,inflammatory markers,and complications.The primary outcomes were reduction in C-reactive protein(CRP)and resolution of SIRS at 72 hours.Secondary outcomes included organ failure,intensive care unit admission,mortality,and length of hospital stay.RESULTS The dextran 40+RLS group demonstrated significantly lower CRP levels.No differences were observed in SIRS changes,fluid overload,refractory status mortality,local complications,or organ failure rates.Hospitalization tended to be shorter in the dextran 40+RLS group(5 days vs 6 days)although not to a statistically significant level(P=0.1).Adverse events were mild and comparable in both groups.CONCLUSION Dextran 40+RLS improved the early CRP response in patients with AP without added complications.Although medium-term outcomes were similar,early benefits support its use in initial management.
