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The effect of restrictive compared to liberal intravenous fluid volume on hypotension in adults undergoing major abdominal surgery.
Hollo, Zachary; McKenzie, Stewart; Kluger, Roman; Peyton, Philip; Melville, Andrew; Phan, Tuong D.
Afiliación
  • Hollo Z; Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
  • McKenzie S; Deakin University, 75 Pigdons Road, Waurn Ponds, Geelong, VIC, Australia.
  • Kluger R; Bendigo Health, 100 Barnard Street, Bendigo, VIC, Australia.
  • Peyton P; Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
  • Melville A; University of Melbourne, Grattan Street, Parkville, VIC, Australia.
  • Phan TD; Austin Health, 145 Studley Road, Heidelberg, VIC, Australia.
Sci Rep ; 14(1): 14401, 2024 06 22.
Article en En | MEDLINE | ID: mdl-38909131
ABSTRACT
In a cardiac output (CO) sub-study of the Restrictive versus Liberal Fluid Therapy in Major Abdominal Surgery (RELIEF) trial, it was shown that restrictive fluid management was associated with lower cardiac index at the end of surgery. However, the association of the fluid protocol with intraoperative blood pressure was less clear. This paper primarily compares rates of hypotension between the two fluid regimens. The haemodynamic effects of these protocols may increase our understanding of perioperative fluid prescription. Using a data set of arterial pressure and cardiac output measurements, this observational cohort study primarily compares intraoperative hypotension rates defined by a mean arterial pressure < 65 mmHg between liberal and restrictive fluid protocols. Secondary analyses explore predictors of invasive mean arterial pressure and doppler-derived cardiac output, including fluid volume regimens and surgical duration. 105 patients had a combined total of 835 haemodynamic data capture events from the beginning to the end of the surgery. Here we report that a restrictive regimen is not associated with a greater proportion of participants who experience at least one episode of hypotension than the liberal regimen 64.1% vs. 61.5% (mean difference 2.6%, 95% CI - 15.9% to 21%, p = 0.78). Duration of surgery was associated with an increased risk of hypotension (OR 1.05, 1 to 1.1, p = 0.038). A fluid restriction protocol compared to liberal fluid administration is not associated with lower blood pressure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Abdomen / Fluidoterapia / Hipotensión Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Abdomen / Fluidoterapia / Hipotensión Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido