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Influence of different intraoperative fluid management on postoperative outcome after abdominal tumours resection

Matej Jenko
Matej Jenko
, 
Katarina Mencin
Katarina Mencin
, 
Vesna Novak-Jankovic
Vesna Novak-Jankovic
 oraz 
Alenka Spindler-Vesel
Alenka Spindler-Vesel
   | 07 mar 2024
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Article Category: Research Article
Data publikacji: 07 mar 2024
Zakres stron: 279 - 288
Otrzymano: 31 sie 2023
Przyjęty: 10 gru 2023
DOI: https://doi.org/10.2478/raon-2024-0015
Słowa kluczowe
© 2024 Matej Jenko et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Consort diagram of the study.
Consort diagram of the study.

Intraoperative fluid management

Control group Median (interquartile range) ml Protocol group Median (interquartile range) ml P-value (Mann – Whitney U test)
Intraoperative blood loss 300 (425) 500 (500) 0.182
RBC transfusion 0 (0) 0 (0) 0.185
FFP transfusion 0 (0) 0 (0) 1
Platelet transfusion 0 (0) 0 (0) 0.317
Intraoperative fluid balance +375 (438) +1300 (1063) 0.0001
Intraoperative urinary output 205 (100) 300 (200) 0.078

Intraoperative observations and interventions

Control group (Number of patients out of 42 with a certain observation/intervention) Protocol group (Number of patients out of 42 with a certain observation/intervention) P-value
Bolus of phenylephrine during procedure 31 38 0.0431,2
Vasoactive support with norepinephrine 1 2 0.5003
Mean arterial pressure less than 70mmHg at any time during the procedure 31 36 0.2262
Mean arterial pressure less than 50mmHg at any time during the procedure 7 8 0.3532

Comparison of length of stay

Control group Median (Interquartile range) days Protocol group Median (Interquartile range) days P-value (Mann – Whitney U test)
Longest stay in the hospital 9 (8) 9 (5.5) 0.851
Duration of stay in the HDU 4 (3) 3 (1.3) 0.122

List of postoperative complications in the first three days after the procedure in both groups

Postoperative complication/intervention Control group (Number of patients out of 42 with a certain observation/intervention) Protocol group (Number of patients out of 42 with a certain observation/intervention) Value P*
Readmission to the HDU 5 1 0.1361
Admission to the ICU 2 0 0.2472
Revision surgery 6 0 0.0261
The patient has died before discharge 1 0 0.5002
Complications related to the operative procedure (dehiscence, inflammation) first day after the procedure 0 2 0.4942
Complications related to the operative procedure (dehiscence, inflammation) third day after the procedure 3 2 12
RBC transfusion needed on the first day after the procedure 2 0 0.5132
RBC transfusion required the second or third day after the procedure. 1 2 0.5002
Acute kidney disease 3 4 0,5002
Troponin leak 0 3 0,2412
Median level of C-reactive protein (difference between highest postoperative level in 3 days and preoperative level) Laboratory reference range (0–5 mcg/L) 125 (118) 115 (122) 0.1063
Median level of procalcitonin (highest postoperative value in the first 3 days) Laboratory reference range (0–0.50 mcg/L) 0.75 (3.19) 0.3 (0.88) 0.0013
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
Kanał RSS czasopisma