About
Background, rationale, and the team behind the GAP Trial.
What is GAP?
GAP is a UK multicentre randomised controlled trial of goal-directed fluid therapy (GDFT) versus standard fluid therapy in adults admitted with acute pancreatitis. The trial is funded by the National Institute for Health and Care Research (NIHR) under the Efficacy and Mechanism Evaluation Programme (reference NIHR510996) and sponsored by Imperial College London.
Why now?
Acute pancreatitis affects approximately 37,000 people across the UK every year. Around one in five patients develops early organ failure within the first 48 hours of admission, and when that failure persists, in-hospital mortality rises from 3–5% to 39–42%. Despite this, there is no consensus on optimal early fluid resuscitation strategy — too little fluid risks under-perfusion, too much risks tissue oedema and respiratory compromise.
What GAP will test
GAP will determine whether goal-directed fluid therapy — using a non-invasive finger-cuff stroke-volume monitor to titrate intravenous fluid in response to the patient’s own haemodynamic signals — can reduce persistent organ failure compared to standard care in the first 48 hours after hospital admission.
Chief Investigator
Mr Farid Froghi is Consultant Hepatobiliary and Pancreatic Surgeon at Imperial College Healthcare NHS Trust and Honorary Clinical Senior Lecturer at Imperial College London. He has led the GAP feasibility programme and the Stage 2 NIHR EME application.