Comparing ringer lactate versus normal saline in acute pancreatitis in first hours: A meta-analysis

Acute pancreatitis (AP) is a situation of acute abdomen that is treated with aggressive fluid resuscitation, specially in the first hours. This method can be done with Ringer Lactate (RL) solution or Normal Saline (NS). This study compares both solutions, LR and NS, in the treatment of AP. The population was anyone with an age over 18 years and was treated with RL (Intervention) or NS (Control) for AP. We made a search on Pubmed, Embase and Cochrane. Therefore, we selected randomized trials which compare the solutions in the first hours. The primary outcomes: mortality, necrosis, systemic inflammatory response syndrome (SIRS) in twenty-four hours, treatment in intensive care unit (ICU) and length of stay. A random-effects model was used for outcomes with high heterogeneity. This meta-analysis included 296 adults from five randomized trials comparing RL and NS as fluid resuscitation in the first hours. The statistics were made with Risk Ratio (RR) between the dichotomous outcomes. Treatment in intensive care unit (ICU), RR 0.39 [95% Cl, 0.18–0.85]; Necrosis, RR 0.46 [95% Cl, 0.24–0.88]; Mortality, RR 0.28 [95% Cl, 0.05–1.66]; Systemic inflammatory response syndrome (SIRS) in 24 h, RR 0.68 [95% Cl, 0.39–1.19]. And for the Length of stay was made a mean difference: -0.36 [95% Cl, −0.94- 0.21]. Then, according to the statistics, it's visible that the use of RL tends to be more beneficial to acute pancreatitis than NS in the initial hours.