Targeting oliguria reversal in perioperative restrictive fluid management does not influence the occurrence of renal dysfunction

Egal, Mohamud; Geus, Hilde R. H. de; Bommel, Jasper van; Groeneveld, A. B. Johan

doi:10.1097/eja.0000000000000416

Cited by 45 publications

(27 citation statements)

References 44 publications

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“…However, this study showed that the incidence of AKI was significantly increased in the intraoperative oliguria group, compared to the non-intraoperative oliguria group. Some studies showed that additional intravenous fluids or diuretics did not protect against AKI in oliguric patients [28][29][30]. However, there have been several studies regarding the association of intraoperative oliguria with AKI in patients undergoing abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

Role of intraoperative oliguria in risk stratification for postoperative acute kidney injury in patients undergoing colorectal surgery with an enhanced recovery protocol: A propensity score matching analysis

et al. 2020

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Background The enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection recommends balanced perioperative fluid therapy. According to recent guidelines, zero-balance fluid therapy is recommended in low-risk patients, and immediate correction of low urine output during surgery is discouraged. However, several reports have indicated an association of intraoperative oliguria with postoperative acute kidney injury (AKI). We investigated the impact of intraoperative oliguria in the colorectal ERAS setting on the incidence of postoperative AKI.

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Section: Discussionmentioning

confidence: 99%

Role of intraoperative oliguria in risk stratification for postoperative acute kidney injury in patients undergoing colorectal surgery with an enhanced recovery protocol: A propensity score matching analysis

et al. 2020

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“…A systematic review and meta-analysis included 15 RCTs (1966 to present) with a total of 1594 adult patients undergoing surgery comparing restrictive fluid management with a conventional fluid management protocol and reporting the occurrence of postoperative AKI. [ 38 ] Interestingly, there was insufficient evidence to associate restrictive fluid management with an increase in oliguria or more frequent occurrence of the AKI. There was no statistically significant difference in acute renal failure occurrence between studies targeting oliguria reversal and not targeting oliguria reversal (OR 0.31; 95% CI, 0.08−1.22; P = 0.088).…”

Section: Liberal Versus Restrictive Fluid Managementmentioning

confidence: 99%

Intraoperative fluid management: Past and future, where is the evidence?

Alghamdi

2018

Saudi J Anaesth

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Currently, there is no consensus about the optimum intraoperative fluid therapy strategy. There is growing body of evidence supports the beneficial effects of adopting “Goal-directed therapy” over either the “liberal” or “restrictive” fluid therapy strategies. In this narrative review, we have presented the evidence to support the optimum strategy for intraoperative therapy. In conclusion, whatever the intravenous fluid replacement strategy used, the anesthesiologist must be prepared to adjust the composition and rate of the fluids administered to provide sufficient intravascular fluid volume for adequate perfusion of vital organs without overwhelming the glycocalyx function with fluid overloads.

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“…61 62 and may cause harm. 63 Therefore, current evidence suggests that low UOP alone should not trigger fluid therapy. The recently completed RELIEF study will be the largest study yet to study the relationship between restrictive versus liberal fluid therapy, perioperative UOP, and postoperative AKI and should provide more evidence: results are expected in 2018.…”

Section: Trials Of Gdftmentioning

confidence: 99%

Perioperative fluid and hemodynamic management within an enhanced recovery pathway

Manning

Dunkman

Miller

2017

Journal of Surgical Oncology

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Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to demonstrate benefits when compared to a restrictive strategy within an optimized enhanced recovery protocol. The ideal monitors, hemodynamic goals, and fluid administration strategy are not well established but may be less important than rational application of thoughtful fluid management strategies.

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Targeting oliguria reversal in perioperative restrictive fluid management does not influence the occurrence of renal dysfunction

Abstract: Our data suggest that, even though event numbers are small, perioperative restrictive fluid management does not increase oliguria or postoperative ARF while decreasing intraoperative fluid intake, irrespective of targeting reversal of oliguria or not.

Cited by 45 publications

References 44 publications

Role of intraoperative oliguria in risk stratification for postoperative acute kidney injury in patients undergoing colorectal surgery with an enhanced recovery protocol: A propensity score matching analysis

Role of intraoperative oliguria in risk stratification for postoperative acute kidney injury in patients undergoing colorectal surgery with an enhanced recovery protocol: A propensity score matching analysis

Intraoperative fluid management: Past and future, where is the evidence?

Perioperative fluid and hemodynamic management within an enhanced recovery pathway

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