Impact of postoperative intravenous fluid administration on complications following elective hepato-pancreato-biliary surgery

Daniel Martin; Panagis M. Lykoudis; Gabriel Jones; David Highton; Alan Shaw; Sarah James; Qiang Wei; Giuseppe Fusai

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Impact of postoperative intravenous fluid administration on complications following elective hepato-pancreato-biliary surgery

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Background: The impact of perioperative intravenous fluid administration on surgical outcomes has been documented in literature, but not specifically studied in the context of hepato-pancreato-biliary (HPB) surgery. This study aimed to investigate the impact of postoperative intravenous fluid administration on intensive care unit (ICU), in this subgroup of patients. Methods: A single-center retrospective cohort of 241 HPB patients was assessed, focusing on intravenous fluid administration in ICU, during the first 24 h. Intravenous fluid variables were compared to hospital stay and postoperative complications. Data were assessed using Spearman's correlation test for bivariate correlations and logistic regression for multivariate analysis. Results: The median volume of intravenous fluid administered in the first 24 h postoperatively was 4380 mL, of which 2200 mL was crystalloid, 1500 mL colloid and 680 mL "other" fluid. Patients with one or more complications had a higher median total intravenous fluid input (4790 vs. 4300 mL), higher col-loid volume (2000 vs. 1500 mL), lower urine output (1595 vs. 1900 mL) and greater overall fluid balance (+3040 vs.+2553 mL) than those without complications. There were correlations between total intra-venous fluid volume administered (r = 0.278, P < 0.001), intravenous colloid input (r = 0.278, P < 0.001), urine output (r = -0.295, P < 0.001), positive fluid balance (r = 0.344, P < 0.001) and length of hospital stay. Logistic regression model was constructed to predict the occurrence of one or more complications;total intravenous fluid volume and overall fluid balance were both independent significant predictors (OR = 2.463, P = 0.007; OR = 1.001, P = 0.011; respectively). Conclusions: Administration of high volumes of intravenous fluids in the first 24 hours post-HPB surgery, along with higher positive fluid balance is associated with a higher rate of complications and longer hospital stay. Moreover, lower urine output is associated with longer hospital stay. Whether these are the cause of complications or the result of them remains unclear.

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《国际肝胆胰疾病杂志（英文版）》 |2018年第5期|402-407|共6页
作者
Daniel Martin; Panagis M. Lykoudis; Gabriel Jones; David Highton; Alan Shaw; Sarah James; Qiang Wei; Giuseppe Fusai;
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作者单位

Division of Surgery & Interventional Science;

University College London;

Gower St;

Bloomsbury;

London;

WC1E 6BT;

UK;

Royal Free Perioperative Research Group;

Royal Free Hospital;

Pond st;

London;

NW32QG;

UK;

Division of Surgery & Interventional Science;

University College London;

Gower St;

Bloomsbury;

London;

WC1E 6BT;

UK;

Department of Hepato-Pancreato-Biliary Surgery & Liver Transplantation;

Royal Free Hospital;

Pond st;

London;

NW32QG;

UK;

King's College Hospital;

Denmark Hill;

London SE59RS;

UK;

Neurocritical Care Unit;

the National Hospital for Neurology and Neurosurgery;

Queen Square;

London;

WC1N 3BG;

UK;

London School of Hygiene & Tropical Medicine;

Keppel Street;

London;

WC1E 7HT;

UK;

Royal Free Perioperative Research Group;

Royal Free Hospital;

Pond st;

London;

NW32QG;

UK;

Division of Hepatobiliary and Pancreatic Surgery;

Department of Surgery;

First Affiliated Hospital;

Zhejiang University School of Medicine;

79 Qingchun Road;

Hangzhou 310003;

China;

Division of Surgery & Interventional Science;

University College London;

Gower St;

Bloomsbury;

London;

WC1E 6BT;

UK;

Department of Hepato-Pancreato-Biliary Surgery & Liver Transplantation;

Royal Free Hospital;

Pond st;

London;

NW32QG;

UK;

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正文语种 eng
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Impact of postoperative intravenous fluid administration on complications following elective hepato-pancreato-biliary surgery

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