Effects of Intravenous Fluid Restriction on Postoperative Complications: Comparison of Two Perioperative Fluid Regimens: A Randomized Assessor-Blinded Multicenter Trial

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Abstract

Objective: To investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection.
Summary Background Data: Current fluid administration in major surgery causes a weight increase of 3–6 kg. Complications after colorectal surgery are reported in up to 68% of patients. Associations between postoperative weight gain and poor survival as well as fluid overload and complications have been shown.
Methods: We did a randomized observer-blinded multicenter trial. After informed consent was obtained, 172 patients were allocated to either a restricted or a standard intraoperative and postoperative intravenous fluid regimen. The restricted regimen aimed at maintaining preoperative body weight; the standard regimen resembled everyday practice. The primary outcome measures were complications; the secondary measures were death and adverse effects.
Results: The restricted intravenous fluid regimen significantly reduced postoperative complications both by intention-to-treat (33% versus 51%, P = 0.013) and per-protocol (30% versus 56%, P = 0.003) analyses. The numbers of both cardiopulmonary (7% versus 24%, P = 0.007) and tissue-healing complications (16% versus 31%, P = 0.04) were significantly reduced. No patients died in the restricted group compared with 4 deaths in the standard group (0% versus 4.7%, P = 0.12). No harmful adverse effects were observed.
Conclusion: The restricted perioperative intravenous fluid regimen aiming at unchanged body weight reduces complications after elective colorectal resection.

Detaljer

Författare
  • Birgitte Brandstrup
  • Randi Beier-Holgersen
  • Else Hjortsø
  • Helle Ørding
  • Karen Lindorff Larsen
  • Morten S Rasmussen
  • Charlotte Lanng
  • Lene Wallin
  • Lene Hjerrild Iversen
  • Christina S Gramkow
  • Mette Okholm
  • Tine Blemmer
  • Poul-Erik Svendsen
  • Henrik Hovgaard F Rottensten
  • Birgit Thage
  • Jens Jakob Riis
  • Inge Jeppesen
  • Dorthe Teilum
  • Anne Mette Christensen
  • Ben Graungaard
  • Frank Christian Pott
  • Danish Study Group on Perioperative Fluid Therapy
Externa organisationer
  • Bispebjerg Hospital
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Kirurgi
Originalspråkengelska
Sidor (från-till)641-648
Antal sidor8
TidskriftAnnals of Surgery
Volym238
Utgåva nummer5
StatusPublished - 2003 nov 1
PublikationskategoriForskning
Peer review utfördJa
Externt publiceradJa