Controversies in the management of acute pancreatitis: An update

Table 2 Recent meta-analyses comparing resuscitation with Ringer’s lactate vs normal saline in patients with acute pancreatitis

Ref.	Inclusion	Conclusion
Zhou et al[17], 2021	4 RCT, 7964 abstracts, 57 full-text documents	Patients resuscitated with RL were less likely to develop moderately severe/severe AP (OR: 0.49; 95%CI: 0.25-0.97), had reduced requirement of ICU admission (OR: 0.33; 95%CI: 0.13-0.81) and had reduced local complications (OR: 0.42; 95%CI: 0.20-0.88)
Aziz et al[18], 2021	4 RCT, 2 cohort studies	Patients resuscitated with RL had a lower rate of ICU admission (RR: 0.43; 95%CI: 0.22-0.84), a lower length of hospital stay (MD: 0.77 d; 95%CI: 1.44-0.09 d) and no difference in overall mortality and SIRS at 24 h
Vedantam et al[19], 2022	6 studies	Patients resuscitated with RL had a decreased need for ICU admission and no statistical difference in the risk of developing SIRS at 24 h (pooled OR: 0.59; 95%CI: 0.22-1.62, P = 0.31)
Chen et al[20], 2022	4 RCT	Patients resuscitated with RL had a reduced incidence of ICU admission (RR: 0.39; 95%CI: 0.18-0.85; P = 0.02), no significant reduction in SIRS at 24 h, 48 h and 72 h and no reduction in risk of mortality, severe disease or local complications

AP: Acute pancreatitis; CI: Confidence interval; ICU: Intensive care unit; MD: Mean difference; OR: Odds ratio; RCT: Randomized controlled trial; RL: Ringer’s lactate; RR: Relative risk; SIRS: Systemic inflammatory response syndrome.