Fluid therapy in acute pancreatitis. A systematic review of literature.

Acute pancreatitis is an acute inflammation of the pancreas associated with a high morbidity and even the risk of mortality [1, 2]. To date, there exists no specific treatment for this disease [3, 4, 5] and fluid therapy forms the cornerstone of management of these patients who present acutely to emergency departments around the world. There is a need to review the data on fluid resuscitation in acute pancreatitis to aid the development of evidence-based guidelines. A systematic search of the scientific literature was carried out using EMBASE, PubMed/MEDLINE, and the Cochrane Central Register of Controlled Trials for the years 1965-2011 to obtain access to all publications, especially randomized controlled trials, systematic reviews, and meta-analyses involving the various factors related to the use of fluid resuscitation in acute pancreatitis. The search strategy was that described by Dickersin et al. [6] with the appropriate specific search terms, namely, “acute pancreatitis”, “fluid resuscitation”, “haemoconcentration”, “hemoconcentration”, “fluids”, “pancreatitis”, “systematic”, and “randomized controlled trials”. All available major publications from the past 45 years were considered. Using the above search strategy, a total of 12 studies were identified describing regimens for fluid therapy. These included two randomized controlled trials, one retrospective cohort study, and 9 reviews.