From the Department of Upper GI Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter.
Department of Surgery, Norwich & Norfolk University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
Pancreas. 2021 Feb 1;50(2):189-195. doi: 10.1097/MPA.0000000000001736.
Early intravenous fluid (IVF) resuscitation is crucial in the management of acute pancreatitis; variation in IVF prescription practice had been demonstrated. This pilot study aims to assess whether the implementation of an Acute Pancreatitis Care Pathway (APCP) produces a change toward a more adequate IVF regimen in the first 24 hours.
Patients with confirmed diagnosis of acute pancreatitis, from July 2015 to February 2016 (group 1) and from September 2017 to March 2018 (group 2), were considered. The APCP was developed between March 2016 and August 2017. Median IVF rate, volume, and type infused in the first 24 hours, were compared between groups. Nonparametric data were analyzed with the Mann-Whitney U test, differences in frequencies with the McNemar test; significance was set at P < 0.05.
Seventy-two patients were included, 36 in each group. In the first 24 hours, the median IVF rate was 177 mL/h vs 225 mL/h (P = 0.004); Ringer lactate infusion was 30% vs 77.8% (P = 0.0003). The median total IVF volume did not differ between groups.
The implementation of the APCP has the potential to lead to a successful change in early IVF resuscitation practice.
急性胰腺炎的治疗中，早期静脉补液（IVF）复苏至关重要；先前已经证实 IVF 处方实践存在差异。本初步研究旨在评估急性胰腺炎护理路径（APCP）的实施是否会使头 24 小时内更合理的 IVF 方案得到实施。
2015 年 7 月至 2016 年 2 月（组 1）和 2017 年 9 月至 2018 年 3 月（组 2）期间确诊为急性胰腺炎的患者被纳入研究。APCP 于 2016 年 3 月至 2017 年 8 月之间开发。比较两组患者在头 24 小时内的 IVF 输注率、量和类型。非参数数据采用曼-惠特尼 U 检验进行分析，采用 McNemar 检验比较频率差异；P 值<0.05 为差异有统计学意义。
共纳入 72 例患者，每组 36 例。在头 24 小时内，IVF 输注率中位数分别为 177 mL/h 和 225 mL/h（P = 0.004）；乳酸林格氏液输注率分别为 30%和 77.8%（P = 0.0003）。两组间总 IVF 量的中位数无差异。
APCP 的实施有可能成功改变早期 IVF 复苏实践。
