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

Overview

Journal Ann Surg

Specialty General Surgery

Date 2003 Oct 28

PMID 14578723

Citations 428

Authors

Birgitte Brandstrup

Hanne Tonnesen

Randi Beier-Holgersen

Else Hjortso

Helle Ording

Karen Lindorff-Larsen

Morten S Rasmussen

Charlotte Lanng

Lene Wallin

Lene H Iversen

Christina S Gramkow

Mette Okholm

Tine Blemmer

Poul-Erik Svendsen

Henrik H Rottensten

Birgit Thage

Jens Riis

Inge S Jeppesen

Dorthe Teilum

Anne Mette Christensen

Ben Graungaard

Frank Pott

Affiliations

Soon will be listed here.

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.

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