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Aggressive intravenous hydration with lactated Ringer's solution for prevention of post-ERCP pancreatitis: A prospective randomized multicenter clinical trial
- Title
- Aggressive intravenous hydration with lactated Ringer's solution for prevention of post-ERCP pancreatitis: A prospective randomized multicenter clinical trial
- Authors
- Park C.-H.; Paik W.H.; Park E.T.; Shim C.S.; Lee T.Y.; Kang C.; Noh M.H.; Yi S.Y.; Lee J.K.; Hyun J.J.
- Ewha Authors
- 이선영
- SCOPUS Author ID
- 이선영
- Issue Date
- 2018
- Journal Title
- Endoscopy
- ISSN
- 0013-726X
- Citation
- Endoscopy vol. 50, no. 4, pp. 378 - 385
- Publisher
- Georg Thieme Verlag
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background and study aims: The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Patients and methods :In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer's solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after ERCP). The primary end point was post-ERCP pancreatitis (PEP). Results :395 patients were enrolled, and 385 completed the protocols. The three groups showed no significant differences in demographic characteristics. There was a significant difference in the intention-to-treat (ITT) PEP rate between the aggressive LRS group (3.0 %, 95 % confidence interval [CI] 0.1 % - 5.9 %; 4 /132), the aggressive NSS group (6.7 %, 95 %CI 2.5 % - 10.9 %; 9 /134) and the standard LRS group (11.6 %, 95 %CI 6.1 % - 17.2 %; 15 /129; P = 0.03). In the two-group comparisons, the ITT PEP rate was significantly lower for the aggressive LRS group than for the standard LRS group (relative risk [RR] 0.26, 95 %CI 0.08 - 0.76; P = 0.008). There was no significant difference in the ITT PEP rate between the aggressive NSS group and the standard LRS group (RR 0.57, 95 %CI 0.26 - 1.27; P = 0.17). Conclusion :Aggressive hydration with LRS is the best approach to intravenous hydration for the prevention of PEP in average-to-high risk patients. © Georg Thieme Verlag KG Stuttgart. New York.
- DOI
- 10.1055/s-0043-122386
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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