Evolution of early fluid therapy in acute pancreatitis: Balancing perfusion needs with fluid toxicity

Table 2 Representative contemporary studies informing fluid selection, reassessment, and precision-oriented practice in acute pancreatitis

Ref.	Year	Study design/population	Main findings	Comment
Li et al[15]	2020	Severe hemoconcentrated AP	More noninvasive ventilation	Pulmonary risk
Lee et al[23]	2021	Randomized trial; LR vs NS	LR favored	Key trial
Chen et al[27]	2022	Updated meta-analysis; LR vs NS	LR superior to NS	Supports LR
Froghi et al[50]	2022	Feasibility RCT of ward-based GDFT	Ward-based reassessment feasible	Practical
Ehsan et al[17]	2024	Updated meta-analysis	No reproducible net benefit	Restrictive
Hong et al[29]	2024	Updated meta-analysis; LR vs NS	Recent evidence favored LR	Consistent
Evans et al[51]	2024	Meta-analysis and trial sequential analysis	Routine aggressive therapy unsupported	Sequential
Kong et al[41]	2025	Machine learning-guided fluid study	ML-guided strategy improved outcomes	Frontier

AP: Acute pancreatitis; GDFT: Goal-directed fluid therapy; LR: Lactated Ringer’s solution; ML: Machine learning; NS: Normal saline; RCT: Randomized controlled trial.