A study shows that intensive serum therapy in acute pancreatitis can be harmful

The Parc Taulí Research and Innovation Institute (I3PT) has participated in one international study that changes the current treatment of patients with acute pancreatitis. The results of the study, in which they have worked researchers Alba Lira and Laura Llovet, from the Digestive System Service, and with the collaboration of Andrea Campos, from the General and Digestive Surgery Service, show that the use of abundant intravenous serum during the first hours and days of admission is not recommended. In addition, it proves that not only does it not prevent complications, but even it can become harmful to patients who suffer from the disease.

The results of the study demonstrate that the use of abundant intravenous serum during the first hours and days of admission is not recommended

THEWATERFALL study, which has been carried out in 19 health and research centers in Spain, India, Italy and Mexico with the participation of 249 patients, and under the leadership of the General University Hospital Dr. Balmis (Alicant), has been published in the magazine The New England Journal of Medicine (NEJM), the most prestigious in the world in clinical medicine.

La pancreatitis is a disease that can be moderate or severe and is the result of acute inflammation of the pancreas and the tissue that surrounds it. Currently, it is the third cause of admission due to disease of the digestive system. Acute pancreatitis produces nausea, vomiting, and severe abdominal pain, which usually resolves within a few days with treatment. However, in one out of three cases, there may be complications that affect the pancreas and even other organs.

Treatment in recent years for patients admitted for acute pancreatitis recommended the abundant infusion of serums with the aim of providing a large amount of fluid to improve blood supply to the pancreas. The published study shows that this practice is not recommended since it can produce a volume overload of the circulatory system and, even, can increase the risk of cardio-pulmonary complications.

This conclusion could change the current clinical practice of acute pancreatitis worldwide

This conclusion could change the current clinical practice of acute pancreatitis worldwide, as the study has been qualified as a "Landmark study" is preferably used for NEJM. The journal publishes an editorial stating how many fluids have been administered to patients.

Article reference

E. de-Madaria, JL Buxbaum, P. Maisonneuve, A. García García de Paredes, P. Zapater, L. Guilabert, A. Vaillo-Rocamora, M.Á. Rodríguez-Gandía, J. Donate-Ortega, EE Lozada-Hernández, AJR Collazo Moreno, A. Lira-Aguilar, LP Llovet, R. Mehta, R. Tandel, P. Navarro, AM Sánchez-Pardo, C. Sánchez-Marin , M. Cobreros, I. Fernández-Cabrera, F. Casals-Seoane, D. Casas Deza, E. Lauret-Braña, E. Martí-Marqués, LM Camacho-Montaño, V. Ubieto, M. Ganuza, and F. Bolado, for the ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. N Engl J Med 2022;387:989-1000. DOI: 10.1056/NEJMoa2202884. https://www.nejm.org/doi/full/10.1056/NEJMoa220288