Early aggressive fluid resuscitation results in a higher incidence of fluid overload and does not improve clinical outcomes for patients presenting with acute pancreatitis, according to a study published in the 15 September issue of the New England Journal of Medicine.

Enrique de-Madaria, MD, PhD, from Dr Balmis General University Hospital in Alicante, Spain, and colleagues randomly assigned 249 patients at 18 centres who presented with acute pancreatitis to receive goal-directed aggressive or moderate resuscitation with lactated Ringer’s solution.

Patients were assessed at 12, 24, 48 and 72 hours; fluid resuscitation was adjusted based on the patient’s clinical status.

The trial was halted due to between-group differences in the safety outcomes, with no significant difference in the incidence of moderately severe or severe pancreatitis between the groups (22.1% and 17.3% in the aggressive- and moderate-resuscitation groups, respectively; adjusted relative risk, 1.30; 95% confidence interval, 0.78 to 2.18; P = 0.32).