Is Lactated Ringer's Superior to Normal Saline in Acute Pancreatitis?

Early administration of intravenous fluid is crucial to improve outcomes and help prevent pancreatic necrosis. Neither lactated Ringer's solution nor normal saline has been shown to be definitively superior for acute pancreatitis (AP); both fluids are recommended by the latest guideline (Gastroenterology 2018; 154:1096). Furthermore, a recent meta-analysis comparing lactated Ringer's and saline in AP showed no difference in mortality or the development of the systemic inflammatory response syndrome, but possibly fewer intensive care unit admissions occurred with lactated Ringer's (Pancreatology 2021; 21:1217).

To examine outcomes with the two fluid types, researchers conducted a prospective, observational, 22-site international study of 1000…