Sierra-Barrales JA, Díaz-Aguilar FA, García-Rodríguez P, Chablé-Chan FG, Calva-Rojas A, Arroyo-Cano FMG

Language: Spanish
References: 14
Page: 186-192
PDF size: 221.79 Kb.

ABSTRACT

Introduction: acute pancreatitis is a serious disease and a frequent cause of admission to emergency services in Mexico. The average fluid intake in the first 24 hours ranged from 4 to 6 liters, a factor that in some cases contributed to high morbidity and mortality.
Objective: to analyze the most frequent complications associated with aggressive fluid resuscitation of acute pancreatitis in the emergency room.
Material and methods: this research is an analytical, observational, cross-sectional, descriptive and retrospective study, which was carried out in patients treated in the Emergency area of General Hospital Zone No. 29; a bivariate analysis was performed using Chi square or Fisher’s exact test, estimating odds ratio (OR) and 95% confidence intervals (95% CI). Medical records were used to obtain information from March 2022 to March 2023.
Results: 201 patients diagnosed with acute pancreatitis were included, aged between 18 and 70 years, 67.7% women (n=136) and 32.3% men (n=65). The severity of admissions was assessed using the Atlanta classification: mild 62.7% (n=126), moderately severe 33.8% (n=68), and severe 3.5% (n=7). Patients resuscitated with 0.9% saline solution were 39.8% (n=80), Hartmann solution 60.2% (n=121). The amount occupied was <3000ml 68.7% (n=138) and >3000ml 31.3%. (n=63), the most frequent complication was peripheral edema with 40.3% (n=81) with an OR=4.41 (CI= 2.4-8.09) and acute pulmonary edema 3% (n=6) OR=1.10 (CI=1.02-1.19).
Conclusion: fluid resuscitation is a pillar in the treatment of acute pancreatitis, however overhydration continues to be a cause of morbidity, so adjusting fluids in emergencies is essential, goal-guided resuscitation, individualization of treatment and the inclusion of some devices would avoid complications.

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