Crystalloid versus colloid fluids for reduction of postoperative ileus after abdominal operation under combined general and epidural anesthesia

Ghodraty, Mohammad Reza; Rokhtabnak, Faranak; Dehghan, Hossein Reza; Pournajafian, Alireza; Vaji, Masoud Baghaee; Koleini, Zahra Sadat; Porhomayon, Jahan; Nader, Nader D.

doi:10.1016/j.surg.2017.06.014

Cited by 17 publications

(32 citation statements)

References 19 publications

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“…vomiting, was significantly lower in patients on a restrictive/ targeted intravenous fluid regime. Studies have also reported similar results when colloids have been administered postoperatively [14,17]. The benefit of this outcome may be explained by cumulative administration of smaller volumes (of colloids) compared to crystalloids.…”

Section: Discussionmentioning

confidence: 68%

“…All studies met the criteria for randomisation and allocation concealment, but a wide variability existed between studies for other domains (blinding of participants and personnel, blinding of outcome assessment and assessor, incomplete outcome data and selective reporting). In the intravenous fluid group, quality assessment for 7 studies [9][10][11][12][13][14][15] ies [16][17][18][19][20][21][22][23][24][25][26] (22%) scored 'fair' (Table 2), and more than half (63%) of the studies were 'poor' (Table 3).…”

Section: Quality Assessmentmentioning

confidence: 99%

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Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis

Asrani

Brown

Bissett

et al. 2020

The Journal of Critical Care Medicine

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IntroductionGastrointestinal dysfunction (GDF) is one of the primary causes of morbidity and mortality in critically ill patients. Intensive care interventions, such as intravenous fluids and enteral feeding, can exacerbate GDF. There exists a paucity of high-quality literature on the interaction between these two modalities (intravenous fluids and enteral feeding) as a combined therapy on its impact on GDF.AimTo review the impact of intravenous fluids and enteral nutrition individually on determinants of gut function and implications in clinical practice.MethodsRandomized controlled trials on intravenous fluids and enteral feeding on GDF were identified by a comprehensive database search of MEDLINE and EMBASE. Extraction of data was conducted for study characteristics, provision of fluids or feeding in both groups and quality of studies was assessed using the Cochrane criteria. A random-effects model was applied to estimate the impact of these interventions across the spectrum of GDF severity.ResultsRestricted/ goal-directed intravenous fluid therapy is likely to reduce ‘mild’ GDF such as vomiting (p = 0.03) compared to a standard/ liberal intravenous fluid regime. Enterally fed patients experienced increased episodes of vomiting (p = <0.01) but were less likely to develop an anastomotic leak (p = 0.03) and peritonitis (p = 0.03) compared to parenterally fed patients. Vomiting (p = <0.01) and anastomotic leak (p = 0.04) were significantly lower in the early enteral feeding group.ConclusionsThere is less emphasis on the combined approach of intravenous fluid resuscitation and enteral feeding in critically ill patients. Conservative fluid resuscitation and aggressive enteral feeding are presumably key factors contributing to severe life-threatening GDF. Future trials should evaluate the impact of cross-interaction between conservative and aggressive modes of these two interventions on the severity of GDF.

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Section: Discussionmentioning

confidence: 68%

Section: Quality Assessmentmentioning

confidence: 99%

Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis

Asrani

Brown

Bissett

et al. 2020

The Journal of Critical Care Medicine

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“…Rasmussen et al also reported that 5% human albumin [45] and Dextran70 [44] affected TEG MA. Dex-tran70 was also associated with the incidence of significant bleeding (>1500 mL) in cystectomy compared to LRS (n (%): [22]. In contrast, Yates et al [16] conducted a large trial (n � 202) that compared balanced crystalloid to balanced 6% HES 130/0.4 (Volulyte).…”

Section: Renal Function (Colloid Vs Colloid/crystalloid)mentioning

confidence: 99%

“…e results showed no difference in the number of patients who tolerated diet at postoperative day 5 (30% vs. 32%) or in the time to first flatus. Table 10 shows four studies that reported the effects of fluid on PONV [19,22,36,42]. Chaudary et al [19] used preoperative intravenous volume loading by LRS and hetastarch.…”

Section: Renal Function (Colloid Vs Colloid/crystalloid)mentioning

confidence: 99%

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

Noonpradej

Akaraborworn

2020

Critical Care Research and Practice

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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.

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Safety and efficacy of tetrastarches in surgery and trauma: a systematic review and meta-analysis of randomised controlled trials

Chappell

Linden

Ripollés‐Melchor

et al. 2021

British Journal of Anaesthesia

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Crystalloid versus colloid fluids for reduction of postoperative ileus after abdominal operation under combined general and epidural anesthesia

Cited by 17 publications

References 19 publications

Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis

Impact of Intravenous Fluids and Enteral Nutrition on the Severity of Gastrointestinal Dysfunction: A Systematic Review and Meta-analysis

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

Safety and efficacy of tetrastarches in surgery and trauma: a systematic review and meta-analysis of randomised controlled trials

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