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UCL Division of Surgery and Interventional Science

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Goal-directed fluid therapy for acute pancreatitis

31 January 2017

The NIHR has awarded £230K to fund a trial led by Prof Brian Davidson, which will look at the possibility of giving fluids using the portable GDFT machine for the first 48 hours to patients admitted with acute pancreatitis.

50 patients will take part in this study and will be followed for 3 months. Half will have the amount of fluids calculated in the normal way, and half using a GDFT machine. Participants in each group will be chosen by chance, not by the doctor or patient deciding. This study looks at the practicality and safety of using GDFT on wards to treat acute pancreatitis and will help design a larger trial to investigate effectiveness and value for money.

Goal-directed fluid therapy for acute pancreatitis

The pancreas helps digest food and control sugar in our blood. Acute pancreatitis affects 18,000 people in the UK every year and 6% die. The pancreas swells and releases chemicals into blood vessels which then leak; vital organs e.g. heart and kidneys don’t get enough oxygen and may stop working. Treatment involves replacing salts and fluids but there is disagreement about how to provide the right amount of fluid. Too little and the kidneys and other organs may fail, but too much can lead to lung and heart failure. Normally, the amount of fluid given is calculated using the patient’s pulse rate, blood pressure, and urine produced. In goal directed fluid therapy (GDFT), the amount is calculated by a machine measuring oxygen in the blood and blood pumped by the heart. GDFT is used in intensive care units, not wards, because special tubes need to be inserted into neck veins. Portable machines that don’t require these tubes are now available allowing GDFT to be performed on the ward. However, it is not clear if GDFT is beneficial for patients with acute pancreatitis.