Fang Likui, Zheng Hong, Yu Wenfeng, Chen Gang, Zhong Fangming
Department of Thoracic Surgery, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Nursing, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Surg. 2021 Aug 4;8:673466. doi: 10.3389/fsurg.2021.673466. eCollection 2021.
The effects of intraoperative fluid management on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the relationship between intraoperative fluid management and postoperative outcomes in these patients. We retrospectively studied 92 patients with constrictive pericarditis undergoing pericardiectomy and assigned them to the restrictive group and the liberal group according to the intraoperative total fluid infusion rate. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the relationship between the intraoperative total fluid infusion rate and postoperative outcomes. There were 46 (50.0%) cases in the restrictive group and 46 (50.0%) cases in the liberal group. Compared with the liberal group, the restrictive group had significantly lower incidences of postoperative complications and cardiac complications ( = 0.005 and = 0.006, respectively). Binary logistics regression analysis also showed the increased risks of postoperative complications (OR, 3.551; 95% CI, 1.192-10.580; = 0.023) and cardiac complications (OR, 6.037; 95% CI, 1.472-25.052; = 0.013) at the liberal group. In addition, the restrictive group had shorter postoperative hospital stay ( = 0.026) in comparison to the liberal group. In patients with constrictive pericarditis undergoing pericardiectomy the intraoperative total fluid infusion rate was significantly associated with postoperative outcomes. Restrictive fluid management strategy was related to the positive effects on enhanced recovery after surgery and could be advised as the preferred intraoperative fluid management policy.
术中液体管理对接受心包切除术的缩窄性心包炎患者的影响尚不清楚。本研究探讨了这些患者术中液体管理与术后结局之间的关系。我们回顾性研究了92例接受心包切除术的缩窄性心包炎患者,并根据术中总输液速率将他们分为限制组和宽松组。比较两组的术后结局。进行二元逻辑回归分析以确定术中总输液速率与术后结局之间的关系。限制组有46例(50.0%),宽松组有46例(50.0%)。与宽松组相比,限制组术后并发症和心脏并发症的发生率显著更低(分别为 = 0.005和 = 0.006)。二元逻辑回归分析还显示,宽松组术后并发症(OR,3.551;95%CI,1.192 - 10.580; = 0.023)和心脏并发症(OR,6.037;95%CI,1.472 - 25.052; = 0.013)的风险增加。此外,与宽松组相比,限制组术后住院时间更短( = 0.026)。在接受心包切除术的缩窄性心包炎患者中,术中总输液速率与术后结局显著相关。限制性液体管理策略与对术后加速康复的积极影响有关,可建议作为首选的术中液体管理策略。