Journal ArticleDOI
Clinical Benefits After the Implementation of a Protocol of Restricted Perioperative Intravenous Crystalloid Fluids in Major Abdominal Operations
José Eduardo de Aguilar-Nascimento,Breno Nadaf Diniz,Aracelle Victor do Carmo,Eryka A. O. Silveira,Raquel de Melo Silva +4 more
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TLDR
Restriction of perioperative intravenous crystalloid fluid is associated with reductions in morbidity and length of postoperative hospital stay after major abdominal operations.Abstract:
Perioperative fluid replacement is a challenging issue in surgical care. The purpose of the present study was to investigate the effect of two different perioperative hydration protocols on the outcome in patients undergoing major abdominal operations. This was a prospective study involving 61 patients (42 men/19 women; mean age: 52 years; age range: 18–81 years) who underwent major abdominal operations. The study had two distinct phases: before (conventional group; administered 30–50 ml/kg per day of crystalloid fluids; n = 33) and after the implementation of a protocol of restricted use of intravenous fluids (restricted group; administered less than 30 ml/kg per day of crystalloid fluids; n = 28). The total volume of intravenous crystalloid fluids infused was recorded until postoperative day (POD) 4. Morbidity, mortality, and the length of postoperative hospital stay were the main clinical variables. Mortality was 4.9% (p > 0.05 between groups). Intravenous therapy in the restricted group was terminated earlier (p < 0.001) and the patients received 2.4 l less crystalloid fluid than did those in the conventional group from POD 1 through POD 4 (p < 0.001). The adoption of the restricted protocol shortened the postoperative hospital stay by 2 days (p = 0.02) and diminished the morbidity by 25% (p = 0.04). Restriction of perioperative intravenous crystalloid fluid is associated with reductions in morbidity and length of postoperative hospital stay after major abdominal operations.read more
Citations
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Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance?
Birgitte Brandstrup,P. E. Svendsen,M. Rasmussen,B. Belhage,S. A. Rodt,B. Hansen,D. R. Møller,L. B. Lundbech,N. Andersen,V. Berg,N. Thomassen,S. T. Andersen,L. Simonsen +12 more
TL;DR: Goal-directed fluid therapy to near-maximal SV guided by ED adds no extra value to the fluid therapy using zero balance and normal BW in patients undergoing elective colorectal surgery.
Journal ArticleDOI
Fluid therapy in the perioperative setting—a clinical review
TL;DR: In elective surgery, the zero-balance approach has shown to reduce postoperative complications and is easily applied for most patients, less expensive and simpler than thezero-balance GDT approach and therefore recommended in this review.
Journal ArticleDOI
Relationship between intraoperative fluid administration and perioperative outcome after pancreaticoduodenectomy: results of a prospective randomized trial of acute normovolemic hemodilution compared with standard intraoperative management.
Mary Fischer,Kenichi Matsuo,Mithat Gonen,Florence Grant,Ronald P. DeMatteo,Michael I. D’Angelica,Jennifer Mascarenhas,Murray F. Brennan,Peter J. Allen,Leslie H. Blumgart,William R. Jarnagin +10 more
TL;DR: In this randomized trial of patients undergoing PD, ANH did not reduce allogeneic transfusions and resulted in more pancreatic anastomotic complications, likely related to greater intraoperative fluid administration.
Journal ArticleDOI
Intravascular Volume Therapy in Adults: Guidelines From the Association of the Scientific Medical Societies in Germany
Gernot Marx,Achim W. Schindler,Christoph Mosch,Joerg Albers,Michael Bauer,Irmela Gnass,Carsten Hobohm,Uwe Janssens,Stefan Kluge,Peter Kranke,Tobias Maurer,Waltraut M. Merz,Edmund Neugebauer,Michael Quintel,Norbert Senninger,Hans-Joachim Trampisch,Christian Waydhas,René Wildenauer,Kai Zacharowski,Michaela Eikermann +19 more
TL;DR: Systematic literature search and selection of evidence, and use of existing guidelines, are reviewed.
Journal ArticleDOI
Fluids and gastrointestinal function
TL;DR: In planning strategies of fluid therapy, the possibility of adverse effects on the gastrointestinal tract should be considered, as this is likely to have an impact on fluid and electrolyte balance and postoperative outcome.
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