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  • Intraoperative fluid restri...
    Ng, Rachel L.; Thomson, Iain G.; Smithers, B. Mark; Booth, Anton W.G.

    Journal of clinical anesthesia, December 2020, 2020-Dec, 2020-12-00, 20201201, Letnik: 67
    Journal Article

    The perioperative intravenous fluid administration in each group was measured from the onset of anaesthesia within two time periods: 0–24 h and 24–48 h. Secondary outcomes were postoperative vasopressor requirements, 30-day mortality, morbidity (including acute kidney injury (AKI), PPC, arrhythmia, anastomotic leak), length of hospital stay and hospital readmission rates. ...intraoperative fluid restriction was not associated with harm and should be considered as the standard for esophagectomy.CRediT authorship contribution statement Rachel L. Ng: Conceptualization, Methodology, Investigation, Writing - original draft, Validation. ERAS N = 61 Traditional care N = 57 P value Intraoperative blood loss; ml 220 (110–400) 350 (200–530) 0.009 Intraoperative fluid administration; ml Crystalloid 1847 (1400–2150) 4000 (3100–5000) <0.001 Colloid 500 (0–784) 1000 (500–1500) <0.001 Total 2300 (1842–2736) 5000 (4000–6000) <0.001 Intraoperative fluid infusion rate; ml·kg−1·h−1 4.1 (3.1–5.3) 9.5 (7.4–11.9) <0.001 Postoperative ICU fluid administration in first 24 h; ml Crystalloid 1355 (1142–1566) 1547 (1355–1745) 0.003 Colloid 250 (0–500) 250 (0–750) 0.60 Total 1675 (1355–2107) 1928 (1534–2484) 0.04 Total fluid administration between 0 and 24 h; ml 3995 (3470–4843) 7214 (5855–8078) <0.001 Total fluid administration between 24 and 48 h; ml 2000 (1520–2408) 1920 (1660–2277) 1.0 Post-operative vasopressor use 19 (31) 18 (32) 0.96 30-day mortality 0 0 Perioperative morbidity Overall 40 (66) 47 (82) 0.04 Major 16 (27) 15 (27) 1.0 Postoperative pulmonary complications Overall 30 (49) 31 (54) 0.59 Major 16 (26) 13 (23) 0.71 Arrhythmia/AF 17 (28) 13 (23) 0.54 Anastomotic leak Overall 14 (23) 9 (16) 0.34 Major (required active intervention) 4 (7) 3 (5) 0.65 Acute kidney injury 8 (13) 13 (23) 0.17 Length of hospital stay; days 11 (8–19) 15 (11–20) 0.008 Readmission to hospital (30 day) 6 (10) 4 (7) 0.56 Table 1 Periopoerative fluid volumes and outcomes.