1/ Basics and must knows in the approach for fluid resuscitation in acute pancreatitis published in a recent review. However, with the lack of high-quality data supporting the use of early aggressive IV fluids, do you practice such? #GITwitter #MedEd
https://journals.lww.com/co-gastroenterology/Abstract/2020/09000/Intravenous_fluid_resuscitation_in_the_management.9.aspx

2/ In the review, early aggressive fluid therapy among acute pancreatitis patients with predicted mild severity appears to have the highest benefit, whereas aggressive resuscitation in patients with predicted severe disease might be futile and deleterious.

3/ A recent meta-analysis showed that early aggressive IVF therapy did not improve mortality and it could potentially increase the risk for AKI and pulmonary edema leading to respiratory failure and mechanical ventilation. @RobertoSimonsMD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081000/

4/ Given the lack of solid ground, the latest AGA guideline has safely stated that a ‘goal-directed therapy for fluid management’ is conditionally recommended for acute pancreatitis. Graded with very low quality evidence.

5/ I guess this is still a question yet unanswered. More studies are needed to answer the question if aggressive IVF is beneficial and in what type of patient it would be beneficial. What do you practice in your patients with acute pancreatitis? #GITwitter #MedEd

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