title: Fluid Choice Matters in Critically-ill Patients with Acute Pancreatitis: Lactated Ringer's vs. Isotonic Saline.
abstract: OBJECTIVE
  To investigate the effect of different crystal- loid solutions on clinical outcomes in critically-ill patients with acute pancreatitis (AP).
  
  
  METHODS
  We conducted a retrospective study of patients with AP admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. We investigated the effect of fluid type; lactated ringer's (LR) vs. isotonic saline (IS) on hospital mortality rates, and ICU length of stay (LOS).
  
  
  RESULTS
  Hospital mortality of the 198 included patients was 12%. For fluid type, 32.9% were resuscitated with LR vs. 67.1% with IS. Hospital mortality was lower in the LR group (5.8%) vs. 14.9% for IS group, odds ratio of 3.10 [P=0.041]. This effect was still observed after adjusting for confounders. However, ICU LOS was longer in LR compared to IS group; 6.2±6.9 vs. 4.2±4.49 days respectively [P= 0.020].
  
  
  CONCLUSIONS
  The type of fluid used for resuscitation in AP may affect the outcome. LR may have survival benefit over IS in critically-ill patients with AP. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island/Alpert Medical School of Brown University.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Aboelsoud
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island/Alpert Medical School of Brown University.
authors.forename: Osama
authors.initials: O
authors.lastname: Siddique
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island/Alpert Medical School of Brown University.
authors.forename: Alexander
authors.initials: A
authors.lastname: Morales
authors.affiliation: Alpert Medical School of Brown University.
authors.forename: Young
authors.initials: Y
authors.lastname: Seol
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island/Alpert Medical School of Brown University, Division of Pulmonary, Critical Care and Sleep Medicine.
authors.forename: Mazen O
authors.initials: MO
authors.lastname: Al-Qadi
mesh_terms: D000208:Acute Disease; D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007552:Isotonic Solutions / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride
keywords: Isotonic Saline; Lactated Ringer’s; acute pancreatitis; critically-ill; resuscitation