Table Info

Table 1.

Studies comparing aggressive hydration with lactate Ringer: study protocol design

Author (country, year) [ref]	Study design	Infusion protocol	Comparison	Number pts	Female gender (%)	Mean age (yrs ± SD)	Patient related PEP risk	Exclusion criteria
Buxbaum et al. (USA, 2014) [30]	RCT (2:1), multicentre	3.0 mL/(kg h) during and for 8 h after ERCP, bolus of 20 mL/kg immediately after the procedure	Standard hydration [LR 1.5 mL/(kg h) during and for 8 h after ERCP, without bolus]	39 aggressive hydration 23 standard hydration	56.5 vs. 48.7	45 ± 17 vs. 43 ± 14	Low and average risk	Previous sphincterotomy Active pancreatitis Cholangitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Pregnancy Age > 70 yrs
Shaygan-Nejad et al. (Iran, 2015) [32]	RCT (1:1), monocentre	3.0 mL/(kg h) during and for 8 h after ERCP, bolus of 20 mL/kg immediately after the procedure	Standard hydration [LR 1.5 mL/(kg h) during and for 8 h after ERCP, without bolus]	75 aggressive hydration 75 standard hydration	64 vs. 68	50.8 ± 13.5 overall	Low and average risk	Previous sphincterotomy Active pancreatitis Cholangitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Pregnancy Age > 70 yrs
Choi et al. (Korea, 2017) [31]	RCT (1:1), multicentre	3.0 mL/(kg h) during and for 8 h after ERCP, bolus of 10 mL/kg before and immediately after the procedure	Standard hydration [LR 1.5 mL/(kg h) during and for 8 h after ERCP, without bolus]	255 aggressive hydration 255 standard hydration	45.5 vs. 45.1	57.0 ± 11.9 vs. 58.2 ± 12.4	Average and high risk	Previous sphincterotomy Active pancreatitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Age < 18 and > 75 yrs Post-surgical anatomy
Park et al. (Korea, 2018) [34]	RCT (1:1:1), multicentre	3.0 mL/(kg h) during and for 8 h after ERCP, bolus of 20 mL/kg immediately after the procedure	a. Aggressive hydration NSS b. Standard hydration LR	132 aggressive LR 134 aggressive NSS 129 standard LR	53 vs. 56 vs. 55	59.0 ± 15.1 vs. 58.1 ± 15.5 vs. 58.9 ± 15.1	Average and high risk	Previous sphincterotomy Sepsis Active pancreatitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Age < 20 and > 80 yrs
Masjedizadeh et al. (Iran, 2017) [36]	RCT (1:1:1), monocentre	3.0 mL/(kg h) for 8 h after ERCP, bolus of 20 mL/kg immediately after the procedure	a. Indomethacin 50 mg before and 50 mg after ERCP b. Nothing	62 aggressive LR 62 indomethacin 62 nothing	48.4 vs. 61.3 vs. 54.8	59.0 ± 15.1 vs. 58.1 ± 15.5 vs. 58.9 ± 15.1	Low and average risk	Previous sphincterotomy Active pancreatitis Cholangitis Sepsis Chronic pancreatitis Fluid overload increased risk* Pregnancy Balloon dilation of papilla Pancreatic stent
Ghaderi et al. (Iran, 2019) [33]	RCT (1:1), monocentre	3.0 mL/(kg h) for 8 h after ERCP, bolus of 20 mL/kg after the procedure	Standard hydration [LR 1.5 mL/(kg h) during and for 8 h after ERCP, without bolus]	120 aggressive hydration 120 standard hydration	51.6 vs. 52.5	51.57 ± 13.5 overall	Low and average risk	Previous sphincterotomy Active pancreatitis Cholangitis Sepsis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Pregnancy Age > 70 yrs
Guha et al. (India, 2023) [37]	RCT (1:1), monocentre	3.0 mL/(kg h) for 8 h after ERCP, bolus of 20 mL/kg after the procedure	Indomethacin 100 mg endorectal	178 aggressive hydration 174 indomethacin	69.9 vs. 71.3	44.0 ± 14.5 overall	Low and average risk	Active pancreatitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Pregnancy Breastfeeding Age > 70 yrs NSAIDs therapy in prior 7 days
Chang et al. (Thailand, 2022) [35]	RCT (1:1), monocentre	3,600 mL LR in 24 h starting 2 h before ERCP	Standard hydration	100 aggressive hydration 100 control group	47 vs. 49	50.9 ± 10.6 vs. 50.4 ± 12.6	Low and average risk	Active pancreatitis Chronic pancreatitis Fluid overload increased risk* Electrolyte alterations Pregnancy Age > 65 yrs Post-surgical anatomy

*: Cardiac, hepatic, respiratory, or renal insufficiency/severe disease; ERCP: endoscopic retrograde cholangiopancreatography; LR: lactated Ringer’s; NSAIDs: non-steroidal anti-inflammatory drugs; NSS: normal saline solution; PEP: post-ERCP acute pancreatitis; pts: patients; RCTs: randomized controlled trials; yrs: years

Supplementary materials

The supplementary materials for this article are available at: https://www.explorationpub.com/uploads/Article/file/1001247_sup_1.pdf.

Declarations

Author contributions

VGM: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. AL: Conceptualization, Validation, Supervision, Writing—review & editing. SG and FF: Writing—review & editing. RS: Validation, Supervision. All authors read and approved the submitted version.

Conflicts of interest

Vincenzo Giorgio Mirante is the Editorial Board Member of Exploration of Medicine. Amedeo Lonardo is the Associate Editor of Exploration of Medicine. They had no involvement in the decision-making or the review process of this manuscript.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

The data analyzed in this study was obtained from PubMed (https://pubmed.ncbi.nlm.nih.gov). Requests for access to these datasets should be directed to Vincenzo Giorgio Mirante (v.mirante@libero.it).

Funding

Not applicable.

Copyright

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