Table 2 Summary & key characteristics of included studies
Study ID, Year of Publication | Study design | Country of origin | Participants | Rate of IV fluids | Intervention | Total IV fluids received | Outcomes |
|---|---|---|---|---|---|---|---|
De-Madaria et al., 2022 [19] | RCT | India, Italy, Spain, and Mexico | 249 | 20 ml/kg bolus followed by 3 ml/kg/hr. vs. 10 ml/kg bolus followed by 1.5 cc/kg/hr. | Lactated Ringer’s solution Moderate vs. Low Fluid resuscitation group | Moderate 8.3 lit. Low 6.6 L | Aggressive vs. Moderate ICU Admissions: 6.6% vs. 1.6% Persistent any organ failure: 6.6% vs. 1.6% Moderately or severe pancreatitis: 22.1% vs. 17.3% Necrotizing pancreatitis: 13.9% vs. 7.1% SIRS at 72 h. 8.8% vs. 14.3 Renal Failure: 7.4% vs. 2.4% Death 3.3% vs. 0.8% Fluid overload: 20.5% vs. 6.3% |
Buxbaum et al., 2017 [18] | RCT | USA | 60 | 20 ml/kg bolus vs. 10 ml/kg | Lactated Ringer’s solution Moderate 20 ml/kg vs. low 10 ml/kg | 7.6 L vs. 5.6 L | Aggressive hydration showed more frequent clinical improvement, SIRS, and less development of hemoconcentration. |
Angsubhakorn et al., 2021 [20] | RCT | Thailand | 46 | 20 ml/kg bolus vs. 10 ml/kg | Lactated Ringer’s solution Moderate 20 ml/kg vs. low 10 ml/kg | 4886 vs. 3985 | 45.5% of 22 patients in aggressive hydration reported improved SIRS vs. 31.82% in standard hydration. |
Cuéllar-Monterrubio et al., 2020 [22] | RCT | Mexico | 88 | 30 ml/kg vs. 20 ml/kg | Hartmann’s solution High 30 ml/kg vs. moderate 20 ml/kg | 8540 vs. 5130 | Patient with non-aggressive hydration developed more AKI as compared to aggressive group (6.9% vs. 11.1%). There is no difference in respiratory complication, pancreatic necrosis, and clinical improvement. |
Lan Li et al., 2019 [27] | Cohort study | China | 912 | > 3 ml/hr vs. <3 ml/hr | Normal saline or Ringer’s lactate solution Moderate vs. Low | NA | Patient with high fluid rate developed more AKI. (22.4% vs. 17.2%) Multiple organ failure: >3 ml/h (28.6% vs. 13.8%) ICU admission: >3 ml/kg/h (87.8% vs. 79.3%) IMV: > 3 ml/kg/h (30.6% vs. 20.7%) NPPV: >3 ml/kg/h (83.7% vs. 62.1%) |
Ahmed A. Messallam et al., 2021 [23] | RCT | USA | 310 | NA | Any fluid (Normal/D5 saline, Ringer’s lactate solution, and others) High vs. moderate vs. low | < 2.8 L vs. 4.5 L vs. > 4.5 L | Organ failure: Aggressive group 16.5 Moderate 7.6 vs. Conservative 4.9% Mortality: 8.7% vs. 2.9% vs. 2.0% Respectively |
Enrique de-Madaria 2011 [21] | Cohort | Spain | 247 | NA | Fluid type not mentioned. Low vs. Moderate vs. High | < 3.1 L vs. 3.1-to-4.1-liter vs. > 4.1 L | High fluids reported more organ failure, respiratory complication and renal failure as compared to low and moderate group. |
Vikesh K Singh 2017 [26] | Cohort | Multiple Countries* | 1010 | NA | Any fluid Low vs. Moderate vs. Low | < 3200 vs. 3200 to 4300 vs. > 4300 | Moderate group associate with lower local complications. No difference in mortality in all groups Aggressive group required more invasive interventions. |
Takahiro Yamashita 2018 [25] | Cohort | Japan | 1097 | NA | Any fluid High vs. Low | 3922 vs. 8706 | Mechanical ventilation Low resuscitation 18.2% vs. High resuscitation 51.7% Renal replacement therapy 75 High resuscitation 10.6% vs. Low resuscitation 22.3% Mortality High resuscitation 15.9% vs. Low resuscitation 10.3% |
Bo Ye et al., 2018 [24] | RCT | China | 179 | NA | Any fluid Moderate vs. Low | Aggressive vs. Nonaggressive 4501 vs. 3316 | Patients with aggressive fluids developed more AKI than non-aggressive fluids. 16.36% vs. 4.86% Aggressive group received more renal replacement therapy than non-aggressive group. 40.63% vs. 24.36% |
Warndorf et al. [29] 2011 | Retrospective study | United states of America | 434 | > 3 ml/hr vs. <3 ml/hr. | Any fluid Early vs. late | Early (< 3 ml/kg/h) vs. Late/rapid (s ≥ 3 ml/ kg/h). | Early resuscitation was associated with decreased SIRS, compared with late resuscitation, at 24 and 72 h as well as reduced organ failure at 72 h a lower rate of admission to the intensive-care unit, and a reduced length of hospital stay |
Gardner et al. [28] 2009 | Retrospective study | United States of America | 45 | > 3 ml/hr vs. <3 ml/hr. | Any fluid Early vs. late | NA | The ‘late resuscitation’ group experienced greater mortality than those in the ‘early resuscitation’ group (18 vs. 0%, p < 0.04) and demonstrated a trend toward greater rates of persistent organ. |