Normal saline vs. lactated ringer's for fluid resuscitation in acute pancreatitis: a systematic review and meta-analysis.

Weijun Jiang, Jingwen Peng, Qiuyue Wu, Shengjie Wang, Peng Zheng, Xinyi Xia

Abstract readSystematic Review

In one paragraph

Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Weijun Jiang *State Key Laboratory of Coordination Chemistry, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, Jiangsu, China.

Jingwen Peng *Department of Critical Care Medicine, Center of Severe Acute Pancreatitis (CSAP), Jinling Hospital, Affiliated Hospital of Medicine School, Nanjing University, Nanjing, Jiangsu, China.

Qiuyue WuState Key Laboratory of Analytical Chemistry for Life Science, Institute of Laboratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.

Shengjie WangDepartment of Basic Medicine, Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, China.

Peng ZhengState Key Laboratory of Coordination Chemistry, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, Jiangsu, China.

Xinyi XiaState Key Laboratory of Analytical Chemistry for Life Science, Institute of Laboratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Intravenous fluid resuscitation is fundamental in acute pancreatitis (AP), but optimal crystalloid selection remains debated. This meta-analysis compares lactated ringer's (LR) and normal saline (NS) for outcomes in AP. Methods: We conducted the systematic review and meta-analysis in accordance with the PRISMA 2020 guidelines. We systematically searched PubMed, Web of Science, Embase, CNKI, and WanFang (Until July 2025) for studies comparing LR and NS in AP. Primary outcomes included mortality, systemic inflammatory response syndrome (SIRS), ICU transfer, pancreatic necrosis, organ failure, and hospital length of stay (LOS). Random- or fixed-effects models were used based on heterogeneity ( Results: Overall mortality did not differ between LR and NS (OR = 1.020, 95% CI: 0.865-1.359, Conclusion: LR and NS demonstrate comparable mortality and safety profiles, with no significant difference in overall LOS. Although LR may shorten LOS in certain subgroups, its association with prolonged LOS in patients with SAP requires further validation. Therefore, based on current evidence, no preference can be recommended for either fluid, and larger standardized trials are warranted. Systematic review registration: CRD420251112118.

Indexed as

acute pancreatitisfluid resuscitationlactated ringermeta-analysisnormal saline

Identifiers

PMID42180723

DOI10.3389/fmed.2026.1792711

PMCPMC13195006

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