Prevalence of Fluid Overload in a Cohort of Patients With Acute Pancreatitis: Results From a Retrospective Tertiary Single-Center Study
Bibliographic record
Abstract
OBJECTIVES: Aggressive fluid expansion has been an undisputed aspect of navigating the early stages of acute pancreatitis. Evidence produced by the WATERFALL trial supports a more conservative approach to fluid resuscitation as patients face higher odds of fluid overload while experiencing no benefit of their underlying condition. This retrospective monocentric observational study seeks to identify fluid-related complications in patients with acute pancreatitis of any grade of severity. METHODS: One hundred twenty-nine patients with acute pancreatitis including moderately severe and severe courses were divided into groups based on their cumulative fluid administration within the first 24 hours (restrictive: <3 L; moderate: 3-6 L; aggressive: >6 L). Vital signs and laboratory values were reported at defined time points. RESULTS: Most patients were allocated to the group of moderate fluid resuscitation. At baseline, patients did not differ in systemic disease severity indicated by critical illness scores. A higher proportion of patients with moderately severe or severe pancreatitis associated with an acute peripancreatic fluid collection had previously been administered >6 L fluids. C-reactive protein levels were significantly higher in patients with >6 L, whereas albumin levels were decreased.Patients receiving >6 L fluids were more likely to show radiologic features of pulmonary fluid overload and be transferred to intensive care unit. In addition, oxygenation markedly deteriorated in aggressively hydrated patients versus restrictive and moderate fluid regimes. CONCLUSIONS: The extent of fluid resuscitation was found to be strongly associated with the prevalence of clinical and radiologic signs of pulmonary fluid overload. Furthermore, moderately severe and severe courses of pancreatitis were more frequently observed in excessively hydrated patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".