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Moderate Versus Aggressive Fluids for Acute Pancreatitis

This study has been completed.
Information provided by (Responsible Party):
James Buxbaum, University of Southern California Identifier:
First received: January 3, 2013
Last updated: July 31, 2016
Last verified: July 2016
Fluid resuscitation for pancreatitis is recommended given evidence that hemoconcentration is associated with necrosis. However, there is insufficient evidence to support whether resuscitation should be moderate or aggressive. In this study the investigators aim to compare the clinical outcome associated with these strategies in a clinical randomized fashion to determine the optimal treatment of acute pancreatitis.

Condition Intervention
Other: Aggressive Hydration
Other: Moderate Hydration

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Moderate Versus Aggressive Fluid Therapy in Patient With Mild to Moderate Acute Pancratitis

Resource links provided by NLM:

Further study details as provided by University of Southern California:

Primary Outcome Measures:
  • Clinical Improvement [ Time Frame: 36 hours ] [ Designated as safety issue: No ]
    Decreased hematocrit, BUN, Cr compared to time zero, decreased epigastric pain, and ability to tolerate PO's.

Secondary Outcome Measures:
  • Time to reach clinical improvement [ Time Frame: 36 hours ] [ Designated as safety issue: No ]
    Time required to reach clinical improvement (as defined in primary outcome measure)

  • Requirement for aggressive hydration [ Time Frame: 36 hours ] [ Designated as safety issue: No ]
    Patients initally in the moderate hydration arm who have an increase in BUN, CR, Hematocrit, or epigastric pain and thus are crossed over to the aggressive hydration arm.

  • Systemic Inflammatory Response Syndrome (SIRS) [ Time Frame: 36 hours ] [ Designated as safety issue: No ]
    SIRS will be defined based on having 2 out of 4 possible criterion. A) heart rate >90, respiratory rate >20, Temperature greater than 100.4 degrees farenheit or less than 96.8 degrees farenheit. White blood count >10 of <4.

  • Severe Pancreatitis [ Time Frame: 36 hours ] [ Designated as safety issue: No ]
    Severe pancreatitis will be defined if 1 of the following is present; pancreatic necrosis (>30%) or abscess, blood pressure <90mmHg, oxygen saturation <90%, Cr >2mg/dl after 12 hours of resuscitation, >10 days hospitalization, or pseudocyst. Pseudocyst is deefined as a peripancreatic fluid collection which does not resorb within 4-8 weeks.

  • Fluid Overload [ Time Frame: 36 hours ] [ Designated as safety issue: Yes ]
    Physical exam findings of pitting edema, ascites, anasacra, pulmonary edema, or dyspnea.

Enrollment: 60
Study Start Date: April 2013
Study Completion Date: November 2015
Primary Completion Date: November 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Aggressive Hydration
Receives Lactated Ringers solution at 3cc/kg/hr following an initial 20cc/kg bolus.
Other: Aggressive Hydration
Receives 20cc/kg bolus and 3cc/kg/hr thereafter.
Active Comparator: Moderate Hydration
Receives Lactated Ringers solution at 1.5cc/kg/hr following an initial 10cc/kg bolus.
Other: Moderate Hydration
Receives 10cc/kg bolus and 1.5cc/kg/hr thereafter.

  Show Detailed Description


Ages Eligible for Study:   18 Years to 70 Years   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • mild to moderate pancreatitis

Exclusion Criteria:

  • SIRS (2/4) a) HR >90 b) RR>20 or paCO2 <32 on room air c) T>100.4 F <96.8 F d) WBC >12, <4 or >10%
  • severe pancreatitis
  • renal insufficiency, Cr >2 mg/dl
  • cardiac insufficiency
  • respiratory insufficiency, O2 saturation <90% room air
  • liver dysfunction, aklbumin <3mg/dL
  • pregnancy
  • hyponatremia, Na < 135meq/L
  • clinical findings of volume overload peripheral edema ascites
  • pancreatitis following endoscopic, radiographic, or surgical procedure
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01761539

United States, California
Los Angeles County Hospital
Los Angeles, California, United States, 90033
Sponsors and Collaborators
University of Southern California
Principal Investigator: James L Buxbaum, MD University of Southern California
  More Information


Responsible Party: James Buxbaum, Director of Endoscopy, Los Angeles County Hospital, University of Southern California Identifier: NCT01761539     History of Changes
Other Study ID Numbers: HS-12-00499 
Study First Received: January 3, 2013
Last Updated: July 31, 2016
Health Authority: United States: Data and Safety Monitoring Board

Keywords provided by University of Southern California:
pancreatitis, alcoholic

Additional relevant MeSH terms:
Pancreatic Diseases
Digestive System Diseases processed this record on October 21, 2016