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Abstract

Background: Acute pancreatitis (AP) is a potentially fatal gastrointestinal condition, often associated with organ failure and acute kidney injury (AKI). Early fluid resuscitation with Normal saline (NS) may lead to hyperchloremia and AKI, which prompted interest in using balanced crystalloids. However, the optimal choice of crystalloid fluid remains uncertain. This study aimed to compare the effects of NS versus Physiomax on plasma chloride levels and AKI incidence during early resuscitation in patients with predicted severe AP (pSAP).

Methods: A single-center, prospective, randomized study was conducted between November 2022 and December 2023 at PGIMER, Chandigarh, India. 112 patients with pSAP were enrolled and randomized (1:1) to receive either NS or Physiomax for fluid resuscitation over the first 48 hours. Primary outcome was plasma chloride concentration at 48 hours. Secondary outcomes included AKI incidence, MAKE-30 events, ICU admissions, and mortality.

Results: Baseline and clinical parameters were comparable between groups. At 48 hours, plasma chloride levels were significantly higher in NS group (114.1±4.3 mmol/L) versus Physiomax group (108.1±3.2 mmol/L; p0.05).

Conclusion: Physiomax significantly reduced plasma chloride levels and AKI incidence in patients with pSAP, suggesting a potential clinical benefit of balanced crystalloids in early AP resuscitation.

DOI

10.55729/2000-9666.1543

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