Fluid administration in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: neither too much nor too little
| Autor: | Ana Sepúlveda Blanco, José Tinoco González, Ana Forastero Rodriguez, Juan Ignacio Medina de Moya, Cristobalina Ángeles Martín García, Gabriel Yanes Vidal, Maria Elvira Castellanos Garijo, Francisco Cristobal Muñoz-Casares, Alicia Merinero Casado, Javier Padillo Ruíz |
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| Přispěvatelé: | Universidad de Sevilla. Departamento de Cirugía |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Fluid administration Colorectal cancer Postoperative Complications Oncotic Pressure Anesthesiology medicine Humans Cytoreductive surgery Peritoneal Neoplasms Retrospective Studies business.industry General Medicine Cytoreduction Surgical Procedures Hyperthermia Induced medicine.disease Combined Modality Therapy Confidence interval Surgery Hyperthermic intraperitoneal chemotherapy Relative risk Female Intraoperative Fluid Therapy Ovarian cancer business Major postoperative complications |
| Zdroj: | Brazilian Journal of Anesthesiology, Volume: 72, Issue: 6, Pages: 695-701, Published: 14 OCT 2022 Brazilian Journal of Anesthesiology, Issue: ahead, Published: 14 OCT 2022 |
| ISSN: | 2352-2291 |
| Popis: | Intraoperative fluid therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy plays an important role in postoperative morbidity. Studies have found an association between overload fluid therapy and increased postoperative complications, advising restrictive intraoperative fluid therapy. Our objective in this study was to compare the morbidity associated with restrictive versus non-restrictive intraoperative fluid therapy.Retrospective analysis of a database collected prospectively in the Anesthesiology Service of Virgen del Roc.ío Hospital, from December 2016 to April 2019. One hundred and six patients who underwent complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were divided into two cohorts according to Fluid Therapy received 1. Restrictive.ß..±.ß9.ßmL.kgsup-1/sup.hsup-1/sup(34 patients), 2. Non-restrictive .ß.ß....ß9.ßmL.kgsup-1/sup.hsup-1/sup(72 patients). Percentage of major complications (Clavien-Dindo grade III...IV) and length hospital stay were the main outcomes variables.Of the 106 enrolled patients, 68.9% were women; 46.2% had ovarian cancer, 35.84% colorectal cancer, and 7.5% peritoneal cancer. The average fluid administration rate was 11.ß...ß3.58.ßmL.kgsup-1/sup.hsup-1/sup. The restrictive group suffered a significantly higher percentage of Clavien-Dindo grade III...IV complications (35.29%) compared with the non-restrictive group (15.27%) (p.ß=.ß0.02). The relative risk associated with restrictive therapy was 1.968 (95% confidence interval: 1.158...3.346). We also found a significant difference for hospital length of stay, 20.91 days in the restrictive group vs 16.19 days in the non-restrictive group (p.ß=.ß0.038).Intraoperative fluid therapy restriction below 9.ßmL.kgsup-1/sup.hsup-1/supin cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was associated with a higher percentage of major postoperative complications. |
| Databáze: | OpenAIRE |
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