Aggressive intravenous hydration with lactated Ringer's solution for prevention of post-ERCP pancreatitis : a prospective randomized multicenter clinical trial
© Georg Thieme Verlag KG Stuttgart · New York..
BACKGROUND AND STUDY AIMS : The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
PATIENTS AND METHODS: In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer's solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after ERCP). The primary end point was post-ERCP pancreatitis (PEP).
RESULTS: 395 patients were enrolled, and 385 completed the protocols. The three groups showed no significant differences in demographic characteristics. There was a significant difference in the intention-to-treat (ITT) PEP rate between the aggressive LRS group (3.0 %, 95 % confidence interval [CI] 0.1 % - 5.9 %; 4 /132), the aggressive NSS group (6.7 %, 95 %CI 2.5 % - 10.9 %; 9 /134) and the standard LRS group (11.6 %, 95 %CI 6.1 % - 17.2 %; 15 /129; P = 0.03). In the two-group comparisons, the ITT PEP rate was significantly lower for the aggressive LRS group than for the standard LRS group (relative risk [RR] 0.26, 95 %CI 0.08 - 0.76; P = 0.008). There was no significant difference in the ITT PEP rate between the aggressive NSS group and the standard LRS group (RR 0.57, 95 %CI 0.26 - 1.27; P = 0.17).
CONCLUSION: Aggressive hydration with LRS is the best approach to intravenous hydration for the prevention of PEP in average-to-high risk patients.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
Endoscopy - 50(2018), 4 vom: 15. Apr., Seite 378-385 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Park, Chang-Hwan [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 14.03.2019 Date Revised 30.03.2022 published: Print-Electronic CRiS: KCT0001398 CommentIn: Endoscopy. 2018 Apr;50(4):460. - PMID 29587332 Citation Status MEDLINE |
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| doi: |
10.1055/s-0043-122386 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM279018525 |
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| 245 | 1 | 0 | |a Aggressive intravenous hydration with lactated Ringer's solution for prevention of post-ERCP pancreatitis |b a prospective randomized multicenter clinical trial |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a CRiS: KCT0001398 | ||
| 500 | |a CommentIn: Endoscopy. 2018 Apr;50(4):460. - PMID 29587332 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Georg Thieme Verlag KG Stuttgart · New York. | ||
| 520 | |a BACKGROUND AND STUDY AIMS : The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis | ||
| 520 | |a PATIENTS AND METHODS: In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer's solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after ERCP). The primary end point was post-ERCP pancreatitis (PEP) | ||
| 520 | |a RESULTS: 395 patients were enrolled, and 385 completed the protocols. The three groups showed no significant differences in demographic characteristics. There was a significant difference in the intention-to-treat (ITT) PEP rate between the aggressive LRS group (3.0 %, 95 % confidence interval [CI] 0.1 % - 5.9 %; 4 /132), the aggressive NSS group (6.7 %, 95 %CI 2.5 % - 10.9 %; 9 /134) and the standard LRS group (11.6 %, 95 %CI 6.1 % - 17.2 %; 15 /129; P = 0.03). In the two-group comparisons, the ITT PEP rate was significantly lower for the aggressive LRS group than for the standard LRS group (relative risk [RR] 0.26, 95 %CI 0.08 - 0.76; P = 0.008). There was no significant difference in the ITT PEP rate between the aggressive NSS group and the standard LRS group (RR 0.57, 95 %CI 0.26 - 1.27; P = 0.17) | ||
| 520 | |a CONCLUSION: Aggressive hydration with LRS is the best approach to intravenous hydration for the prevention of PEP in average-to-high risk patients | ||
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| 700 | 1 | |a Park, Eun Taek |e verfasserin |4 aut | |
| 700 | 1 | |a Shim, Chan Sup |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Tae Yoon |e verfasserin |4 aut | |
| 700 | 1 | |a Kang, Changdon |e verfasserin |4 aut | |
| 700 | 1 | |a Noh, Myung Hwan |e verfasserin |4 aut | |
| 700 | 1 | |a Yi, Sun Youn |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jong Kyun |e verfasserin |4 aut | |
| 700 | 1 | |a Hyun, Jong Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jun Kyu |e verfasserin |4 aut | |
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