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Intravenous hydration is standard care for patients with acute pancreatitis, but what infusion rate is appropriate? In a randomized trial, researchers compared two rates of administration of lactated Ringer's solution in 60 patients with acute pancreatitis (caused by alcohol or gallstones in most cases). Patients in the “aggressive” treatment group received a 20 mL/kg bolus followed by 3 mL/kg/hour; the “standard” group received half that amount (10 mL/kg bolus followed by 1.5 mL/kg/hour). Patients were excluded if they had systemic inflammatory response syndrome, signs of volume overload, heart failure, decompensated cirrhosis, serum creatinine >2 mg/dL, or pancreatic abscess or necrosis.
The composite primary outcome had three requirements…