The impact of intravenous fluid administration on complication rates in bowel surgery within an enhanced recovery protocol: a randomized controlled trial

Zakhaleva, Julia; Tam, J.; Denoya, Paula; Bishawi, Muath; Bergamaschi, Roberto

doi:10.1111/codi.12180

Cited by 43 publications

(51 citation statements)

References 20 publications

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“…2) and table (Additional file 1). A total of 26 studies (58%) [1, 3, 11–13, 27, 28, 31, 32, 36–38, 40, 43, 45–47, 50, 51, 57–59, 61, 62, 64, 65] were judged to carry a low risk of bias (Table 1). Weighted kappa was calculated to examine agreement for each component and overall risk of bias assessment.…”

Section: Resultsmentioning

confidence: 99%

“…Eight trials [26, 29, 30, 46, 50, 53, 54, 56] used pulmonary arterial catheters for monitoring; fourteen trials [3, 11, 14, 32, 33, 36, 42, 44, 48, 49, 51, 55, 62, 64] used esophageal Doppler monitoring; fifteen trials [3, 12, 27, 28, 31, 38, 39, 41, 43, 45, 52, 59–61, 65] used self-calibrating/calibrated pulse contour analysis monitoring; and the remaining eight trials used other monitors, including arterial lines plus monitoring equipment [40], central lines and arterial line sampling [34, 37, 57], pulse oximeters [35, 58], and other noninvasive monitors [13, 47]. Three types of goals were used in the majority of included trials, including DO 2 I and/or cardiac index [13, 26, 29, 30, 43, 46, 50, 53, 54, 56, 59], optimal SV [1, 11, 28, 32, 33, 36, 38, 39, 42, 44, 48, 49, 51, 55], and dynamic measures of preload responsiveness (e.g., PPV, SVV, PVI) [12, 27, 31, 35, 40, 41, 45, 52, 58, 60, 61, 65].…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-three trials [1, 11, 14, 26–36, 38–43, 46, 48, 50, 52, 53, 56, 57, 60, 62, 64, 65] provided data on long-term mortality, and further information was obtained from a previous meta-analysis [8] for one study [44]. The long-term mortality was 242 (8.1%) of 2959 in the GDHT group and 285 (9.9%) of 2888 in the control group, and the pooled RR of 0.80 showed that use of perioperative GDHT was barely associated with improved long-term survival after major abdominal surgery compared with the control group (95% CI 0.64–99, p = 0.04; I 2 = 4%) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-four studies [1, 11–14, 26–36, 38–41, 43, 44, 46–48, 50, 52–54, 56, 60, 62, 64, 65] provided suitable data for analysis. The pooled short-term mortality was 153 (5.2%) of 2959 in the GDHT group and 203 (7.0%) of 2888 in the control group, and the RR was 0.75 (95% CI 0.61–0.91, p = 0.004; I 2 = 0%), showing a significant reduction in the GDHT group (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Effect of perioperative goal-directed hemodynamic therapy on postoperative recovery following major abdominal surgery—a systematic review and meta-analysis of randomized controlled trials

et al. 2017

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BackgroundGoal-directed hemodynamic therapy (GDHT) has been used in the clinical setting for years. However, the evidence for the beneficial effect of GDHT on postoperative recovery remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the effect of perioperative GDHT in comparison with conventional fluid therapy on postoperative recovery in adults undergoing major abdominal surgery.MethodsRandomized controlled trials (RCTs) in which researchers evaluated the effect of perioperative use of GDHT on postoperative recovery in comparison with conventional fluid therapy following abdominal surgery in adults (i.e., >16 years) were considered. The effect sizes with 95% CIs were calculated.ResultsForty-five eligible RCTs were included. Perioperative GDHT was associated with a significant reduction in short-term mortality (risk ratio [RR] 0.75, 95% CI 0.61–0.91, p = 0.004, I 2 = 0), long-term mortality (RR 0.80, 95% CI 0.64–0.99, p = 0.04, I 2 = 4%), and overall complication rates (RR 0.76, 95% CI 0.68–0.85, p < 0.0001, I 2 = 38%). GDHT also facilitated gastrointestinal function recovery, as demonstrated by shortening the time to first flatus by 0.4 days (95% CI −0.72 to −0.08, p = 0.01, I 2 = 74%) and the time to toleration of oral diet by 0.74 days (95% CI −1.44 to −0.03, p < 0.0001, I 2 = 92%).ConclusionsThis systematic review of available evidence suggests that the use of perioperative GDHT may facilitate recovery in patients undergoing major abdominal surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1728-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effect of perioperative goal-directed hemodynamic therapy on postoperative recovery following major abdominal surgery—a systematic review and meta-analysis of randomized controlled trials

et al. 2017

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“…Primena ezofagealnog dopler monitoringa postaje sve učestalija. Veliki broj studija potvrdio je da ciljana i individualizovana nadoknada tečnosti (goal directed therapy) daje najbolje ishode kod pacijenata u perioperativnom periodu, kao i u terapiji kritično obolelih 17,18,19 . Individualizovana nadoknada se zasniva na postizanju optimalnog udarnog volumena.…”

Section: Doze I Volumeni Rastvoraunclassified

Use of infusion solutions in critically ill: Literature review

Cvetković¹,

Popović²,

Stojanović³

2016

Serb J Anes Inten Therap

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Association Between Anesthesiologist Volume and Short-term Outcomes in Complex Gastrointestinal Cancer Surgery

et al. 2021

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care is crucial to high-quality surgical care. The clinical expertise and experience of anesthesiologists may decrease the risk of adverse outcomes.OBJECTIVE To examine the association between anesthesiologist volume and short-term postoperative outcomes for complex gastrointestinal (GI) cancer surgery. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study used administrative health care data sets from various data sources in Ontario, Canada. Adult patients who underwent esophagectomy, pancreatectomy, or hepatectomy for GI cancer from January 1, 2007, to December 31, 2018, were eligible. Patients with an invalid identification number, a duplicate surgery record, and missing primary anesthesiologist information were excluded.EXPOSURES Primary anesthesiologist volume was defined as the annual number of procedures of interest (esophagectomy, pancreatectomy, and hepatectomy) supported by that anesthesiologist in the 2 years before the index surgery. Volume was dichotomized into low-volume and high-volume categories, with 75th percentile or 6 or more procedures per year selected as the cutoff point. MAIN OUTCOME AND MEASURESThe primary outcome was a composite of 90-day major morbidity (with a Clavien-Dindo classification grade 3-5) and readmission. Secondary outcomes were individual components of the primary outcome. The association between exposure and outcomes was examined using multivariable logistic regression models, accounting for potential confounders. RESULTSOf the 8096 patients included, 5369 were men (66.3%) and the median (interquartile range [IQR]) age was 65 (57-72) years. Operations were supported by 842 anesthesiologists and performed by 186 surgeons, and the median (IQR) anesthesiologist volume was 3 (1.5-6) procedures per year. A total of 2166 patients (26.7%) received care from high-volume anesthesiologists. Primary outcome occurred in 36.3% of patients in the high-volume group and 45.7% of patients in the low-volume group. After adjustment, care by high-volume anesthesiologists was independently associated with lower odds of the primary outcome (adjusted odds ratio [aOR], 0.85; 95% CI, 0.76-0.94), major morbidity (aOR, 0.83; 95% CI, 0.75-0.91), unplanned intensive care unit admission (aOR, 0.84; 95% CI, 0.76-0.94), but not readmission (aOR, 0.87; 95% CI, 0.73-1.05) or mortality (aOR, 1.05; 95% CI, 0.84-1.31). E-values analysis indicated that an unmeasured variable would unlikely substantively change the observed risk estimates.CONCLUSIONS AND RELEVANCE This study found that, among adults who underwent complex gastrointestinal cancer surgery, those who received care from high-volume anesthesiologists had a lower risk of adverse postoperative outcomes compared with those who received care from low-volume anesthesiologists. These findings support organizing perioperative care to increase anesthesiologist volume to optimize patient outcomes.

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The impact of intravenous fluid administration on complication rates in bowel surgery within an enhanced recovery protocol: a randomized controlled trial

Abstract: Intra-operative administration of iv water and electrolyte during bowel surgery, based on stroke volume measured using oesophageal Doppler, was associated with decreased complication rates.

Cited by 43 publications

References 20 publications

Effect of perioperative goal-directed hemodynamic therapy on postoperative recovery following major abdominal surgery—a systematic review and meta-analysis of randomized controlled trials

Effect of perioperative goal-directed hemodynamic therapy on postoperative recovery following major abdominal surgery—a systematic review and meta-analysis of randomized controlled trials

Use of infusion solutions in critically ill: Literature review

Association Between Anesthesiologist Volume and Short-term Outcomes in Complex Gastrointestinal Cancer Surgery

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