{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:49:38Z","timestamp":1791942578731,"version":"4.3.4"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute pancreatitis (AP) is a common presentation in patients admitted with acute abdomen. Whether Ringers lactate (RL) or Normal Saline (NS) as a resuscitation fluid is better still remains unclear. The aim of this study is to compare the efficacy of RL and NS in terms of control of systemic inflammation by measuring indirect markers specifically Systemic Inflammation Response Syndrome (SIRS) scores and C- Reactive Protein (CRP) level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an open label randomized trial conducted in a tertiary level hospital of Nepal. Ethical approval was obtained prior to the study. Patients with acute pancreatitis were randomized to either RL or NS group for the fluid resuscitation. The fluid was given as per the study protocol for three days for hydration. Baseline SIRS and CRP were recorded on admission and subsequently as defined. All the data were analyzed using SPSS ver 20.0 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total 51 patients were enrolled, 26 in RL and 25 in NS group. The commonest etiology of AP was alcohol (84.31%). SIRS was present in 46.2% and 64.0% of patients in RL and NS group respectively (p = 0.20) on admission. At least one SIRS criteria was still present in 44.0% of patients in the NS group compared to only 15.4% in the RL group after 24 hours (p = 0.025). The baseline CRP were comparable in both the groups. However after 72 hours, the increment of CRP was more in the NS group compared to the RL group; median value of 14.2 mg\/dl (12.15, 16.45) and 22.2 mg\/dl (18.20, 30.60) in RL and NS group respectively (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ringers lactate was associated with a reduction in systemic inflammation compared to normal saline in patients with acute pancreatitis. Incidence of SIRS at 72 hours and occurrence of local complications were however similar in both the groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0263221","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T13:29:46Z","timestamp":1643376586000},"page":"e0263221","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Intravenous Ringers lactate versus normal saline for predominantly mild acute pancreatitis in a Nepalese Tertiary Hospital"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4650-9561","authenticated-orcid":true,"given":"Binod","family":"Karki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dibas","family":"Khadka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjit","family":"Karki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit","family":"Khanal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramila","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bidhan Nidhi","family":"Paudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"pone.0263221.ref001","doi-asserted-by":"crossref","first-page":"g4859","DOI":"10.1136\/bmj.g4859","article-title":"Acute Pancreatitis","volume":"349","author":"CD Johnson","year":"2014","journal-title":"BMJ"},{"key":"pone.0263221.ref002","article-title":"American College of Gastroenterology Guideline: Management of Acute Pancreatitis","author":"S Tenner","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"pone.0263221.ref003","first-page":"969","volume-title":"Sleisenger and Fordtran\u2019s Gastrointestinal and Liver Disease","author":"S Tenner","year":"2016","edition":"1"},{"key":"pone.0263221.ref004","doi-asserted-by":"crossref","first-page":"547e50","DOI":"10.1097\/MPA.0b013e318215368d","article-title":"Decreased mortality in acute pancreatitis related to early aggressive hydration","volume":"40","author":"I Wall","year":"2011","journal-title":"Pancreas"},{"key":"pone.0263221.ref005","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1097\/00000542-199905000-00007","article-title":"Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery","volume":"90","author":"S Scheingraber","year":"1999","journal-title":"Anesthesiology"},{"key":"pone.0263221.ref006","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/j.cgh.2009.08.012","article-title":"Early systemic inflammatory response syndrome is associated with severe acute pancreatitis","volume":"7","author":"VK Singh","year":"2009","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"1","key":"pone.0263221.ref007","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s12664-017-0728-6","article-title":"Role of bedside pancreatic scores and C-reactive protein in predicting pancreatic fluid collections and necrosis","volume":"36","author":"DB Vinish","year":"2017","journal-title":"Indian J Gastroenterol"},{"key":"pone.0263221.ref008","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.cgh.2013.07.042","article-title":"Validation of the determinant-based classification and revision of the Atlanta classification systems foracute pancreatitis","volume":"12","author":"NG Acevedo-Piedra","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"pone.0263221.ref009","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis\u20142012: revision of the Atlanta classification and definitions by international consensus","volume":"62","author":"PA Banks","year":"2013","journal-title":"Gut"},{"issue":"192","key":"pone.0263221.ref010","doi-asserted-by":"crossref","first-page":"580","DOI":"10.31729\/jnma.2430","article-title":"Validation of moderately severe acute pancreatitis in patients with acute pancreatitis","volume":"52","author":"PJ Lakhey","year":"2013","journal-title":"J Nepal Med Assoc."},{"key":"pone.0263221.ref011","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.cgh.2011.04.026","article-title":"Lactated Ringer\u2019s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis","volume":"9","author":"BU Wu","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"key":"pone.0263221.ref012","doi-asserted-by":"crossref","first-page":"9367","DOI":"10.3748\/wjg.v21.i31.9367","article-title":"Fluid resuscitation in acute pancreatitis: normal saline or lactated Ringer\u2019s solution?","volume":"21","author":"M Lipinski","year":"2015","journal-title":"World JGastroenterol"},{"key":"pone.0263221.ref013","first-page":"39","article-title":"Fluid choice matters in critically-ill patients with acute pancreatitis: lactated Ringer\u2019s vs. isotonic saline","volume":"99","author":"MM Aboelsoud","year":"2016","journal-title":"R I Med J"},{"issue":"Suppl 1","key":"pone.0263221.ref014","doi-asserted-by":"crossref","first-page":"S72","DOI":"10.1016\/S0016-5085(17)30594-2","article-title":"Comparison of normal saline versus lactated Ringer\u2019s solution for fluid resuscitation in patients with acute pancreatitis, a randomized controlled trial","volume":"152","author":"S Choosakul","year":"2017","journal-title":"Gastroenterology"},{"key":"pone.0263221.ref015","article-title":"Fluid resuscitation with lactated Ringer\u2019s solution vs normal saline in acute pancreatitis: a triple-blind, randomized, controlled trial","author":"E De-Madaria","year":"2017","journal-title":"United European Gastroenterol J"},{"issue":"3","key":"pone.0263221.ref016","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1053\/j.gastro.2020.10.044","article-title":"Lactated Ringers vs Normal Saline Resuscitation for Mild Acute Pancreatitis: A Randomized Trial","volume":"160","author":"A Lee","year":"2021","journal-title":"Gastroenterology"},{"key":"pone.0263221.ref017","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1042\/cs1040017","article-title":"normal saline and physiological Hartmann\u2019s solution: a randomized double-blind crossover study","volume":"104","author":"F Reid","year":"2003","journal-title":"Clin Sci (Lond)"},{"key":"pone.0263221.ref018","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1213\/ane.0b013e3181732d64","article-title":"The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation","volume":"107","author":"N Hadimioglu","year":"2008","journal-title":"Anesth Analg"},{"key":"pone.0263221.ref019","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/08860220802064770","article-title":"Effects of normal saline vs lactated Ringer\u2019s during renal transplantation","volume":"30","author":"MR Khajavi","year":"2008","journal-title":"Ren Fail"},{"key":"pone.0263221.ref020","first-page":"636","article-title":"Lactated Ringer\u2019s is superior to normal saline in the resuscitation of uncontrolled hemorrhagic shock","volume":"62","author":"SR Todd","year":"2007","journal-title":"J Trauma"},{"key":"pone.0263221.ref021","doi-asserted-by":"crossref","first-page":"R686","DOI":"10.1152\/ajpregu.00564.2003","article-title":"Lactic and hydrochloric acids induce different patterns of inflammatory response in LPS-stimulated RAW 264.7 cells","volume":"286","author":"JA Kellum","year":"2004","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"pone.0263221.ref022","doi-asserted-by":"crossref","first-page":"13410","DOI":"10.1074\/jbc.M112.426254","article-title":"Extracellular acidosis is a novel danger signal alerting innate immunity via the NLRP3 inflammasome","volume":"288","author":"K Rajam\u00e4ki","year":"2013","journal-title":"J Biol Chem"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T13:30:03Z","timestamp":1643376603000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263221"}},"subtitle":[],"editor":[{"given":"Vasilis","family":"Kosmoliaptsis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,28]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0263221","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,28]]}}}