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Complications of fluidotherapy in patients with acute pancreatitis: A contribution

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Summary: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.
Main Authors:Henriques, Carla
Other Authors:Pereira, Jorge; Matos, Ana; Afonso, Catarina
Subject:Acute pancreatitis Fluidotherapy Complications ROC curves Logistic regression
Year:2018
Country:Portugal
Document type:article
Access type:open access
Associated institution:Instituto Politécnico de Viseu
Language:English
Origin:Repositório Científico do Instituto Politécnico de Viseu
Description
Summary: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.