scholarly journals Intravenous Fluid of Choice in Major Abdominal Surgery: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Seechad Noonpradej ◽  
Osaree Akaraborworn
Keyword(s):  
Systematic Review ◽  
Renal Function ◽  
Abdominal Surgery ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Volume Effect ◽  
Intravenous Fluid ◽  
Major Abdominal Surgery ◽  
Intravascular Volume ◽  
Hemodynamic Status

Background. Intravenous fluid therapy plays a role in maintaining the hemodynamic status for tissue perfusion and electrolyte hemostasis during surgery. Recent trials in critically ill patients reported serious side effects of some types of fluids. Since the most suitable type of fluid is debatable, a consensus in perioperative patients has not been reached. Method. We performed a systematic review of randomized control trials (RCTs) that compared two or more types of fluids in major abdominal surgery. The outcomes were related to bleeding, hemodynamic status, length of hospital stay, and complications, such as kidney injury, electrolyte abnormality, major cardiac adverse event, nausea, vomiting, and mortality. A literature search was performed using Medline and EMBASE up to December 2019. The data were pooled to investigate the effect of fluid on macrocirculation and intravascular volume effect. Results. Forty-three RCTs were included. Eighteen fluids were compared: nine were crystalloids and nine were colloids. The results were categorized into macrocirculation and intravascular volume effect, microcirculation, anti-inflammatory parameters, vascular permeability, renal function (colloids), renal function and electrolytes (crystalloids), coagulation and bleeding, return of bowel function, and postoperative nausea vomiting (PONV). We found that no specific type of fluid led to mortality and every type of colloid was equivalent in volume expansion and did not cause kidney injury. However, hydroxyethyl starch and dextran may lead to increased bleeding. Normal saline can cause kidney injury which can lead to renal replacement therapy, and dextrose fluid can decrease PONV. Conclusion. In our opinion, it is safe to give a balanced crystalloid as the maintenance fluid and give a colloid, such as HES130/0.4, 4% gelatin, or human albumin, as a volume expander.

scholarly journals SP279POSTOPERATIVE ACUTE KIDNEY INJURY, LONG-TERM RENAL FUNCTION AND MORTALITY IN PATIENTS UNDERGOING MAJOR ABDOMINAL SURGERY: A COHORT ANALYSIS

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii471-iii471
Author(s):  
Natacha Rodrigues ◽  
Joana Gameiro ◽  
Catarina Bekermen ◽  
Joana Neves ◽  
Maria João Melo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Abdominal Surgery ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Major Abdominal Surgery

scholarly journals Acute kidney injury, long-term renal function and mortality in patients undergoing major abdominal surgery: a cohort analysis

2016 ◽  
Vol 9 (2) ◽  
pp. 192-200 ◽  
Author(s):  
Joana Gameiro ◽  
Joana Briosa Neves ◽  
Natacha Rodrigues ◽  
Catarina Bekerman ◽  
Maria João Melo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Abdominal Surgery ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Major Abdominal Surgery

scholarly journals Preoperative Albuminuria and Intraoperative Chloride Load: Predictors of Acute Kidney Injury Following Major Abdominal Surgery

2018 ◽  
Vol 7 (11) ◽  
pp. 431 ◽  
Author(s):  
Diamantina Marouli ◽  
Kostas Stylianou ◽  
Eleftherios Papadakis ◽  
Nikolaos Kroustalakis ◽  
Stavroula Kolyvaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Abdominal Surgery ◽  
Care Center ◽  
Chronic Kidney Disease Stage ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Major Abdominal Surgery ◽  
Disease Stage ◽  
Postoperative Aki

Background: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery. Methods: This was a prospective, observational study of patients undergoing major abdominal surgery in a tertiary care center. Postoperative AKI was diagnosed according to the Acute Kidney Injury Network criteria within 48 h after surgery. Patients with chronic kidney disease stage IV or V were excluded. Logistic regression analysis was used to evaluate the association between perioperative factors and the risk of developing postoperative AKI. Results: Eleven out of 61 patients developed postoperative AKI. Four intra-operative variables were identified as predictors of AKI: intra-operative blood loss (p = 0.002), transfusion of fresh frozen plasma (p = 0.004) and red blood cells (p = 0.038), as well as high chloride load (p = 0.033, cut-off value > 500 mEq). Multivariate analysis demonstrated an independent association between AKI development and preoperative albuminuria, defined as a urinary Albumin to Creatinine ratio ≥ 30 mg·g−1 (OR = 6.88, 95% CI: 1.43–33.04, p = 0.016) as well as perioperative chloride load > 500 mEq (OR = 6.87, 95% CI: 1.46–32.4, p = 0.015). Conclusion: Preoperative albuminuria, as well as a high intraoperative chloride load, were identified as predictors of postoperative AKI in patients undergoing major abdominal surgery.

scholarly journals Doppler resistive index to reflect risk of acute kidney injury after major abdominal surgery: A prospective observational trial

2019 ◽  
Vol 63 (7) ◽  
pp. 551 ◽  
Author(s):  
Satyen Parida ◽  
Kavitha Muthukrishnan ◽  
SDeepak Barathi ◽  
AshokShankar Badhe ◽  
SandeepKumar Mishra
Keyword(s):  
Acute Kidney Injury ◽  
Abdominal Surgery ◽  
Resistive Index ◽  
Kidney Injury ◽  
Major Abdominal Surgery ◽  
Observational Trial

The safety of restrictive fluid therapy for major abdominal surgery: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Ping Li ◽  
Sheng-Wen Wu ◽  
Dong-Fang Ge ◽  
Zai-Rong Tang ◽  
Cong-Chao Ma ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Enhanced Recovery ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Major Abdominal Surgery ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Clinical Trials Registry

Abstract Background: Restrictive fluid therapy is essential to enhanced recovery after surgery. A meta-analysis was conducted to explore the safety of restrictive fluid therapy for major abdominal surgery and compare it with liberal fluid therapy. Methodology : We searched MEDLINE, the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs), the WHO International Clinical Trials Registry Platform, and EMBASE in which restrictive and liberal fluid therapies were compared. Data on complications, anastomotic leaks, and wound infections were extracted. Results: Eleven RCTs comparing the two therapies were included. Compared with liberal fluid therapy, restrictive fluid therapy lowered the risk of complications and cardiopulmonary dysfunction and had similar rates of mortality, anastomotic leak, pneumonia and would infection. But increased kidney injury was also observed in restrictive fluid therapy. Conclusion: Restrictive fluid therapy is safe but may have potential dangers, so caution is warranted in its application.

scholarly journals Prehabilitation Before Major Abdominal Surgery: A Systematic Review and Meta-analysis

2019 ◽  
Vol 43 (7) ◽  
pp. 1661-1668 ◽  
Author(s):  
Michael J. Hughes ◽  
Rosie J. Hackney ◽  
Peter J. Lamb ◽  
Stephen J. Wigmore ◽  
D. A. Christopher Deans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Meta Analysis ◽  
Major Abdominal Surgery
Sign in / Sign up

Export Citation Format

Share Document