Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey.
General Surgery Department, İnönü University, Malatya, Turkey.
BMC Anesthesiol. 2024 Aug 29;24(1):299. doi: 10.1186/s12871-024-02679-3.
Planning intraoperative fluid therapy in patients undergoing major abdominal surgery is important. It was aimed to define the difference between fluid therapy protocols for renal function, bleeding and postoperative service follow-ups.
This is an observational case-controlled prospective study. Sixty patients aged 18-65 years who had undergone pancreatic surgery between December 2023- February 2023 were included in the study. Liberal (Group 1; n = 30) and targeted fluid therapies (Group 2; n = 30) were administered to the patients. Liberal fluid therapy was planned with 8-10 ml/kg/h crystalloid infusion. The targeted fluid therapy (TFT) group (Group 2; n = 30) began with a 2 ml/kg/h crystalloid infusion at the baseline. Additional fluid boluses were given in 250 ml of colloid infused over 10 min if PVI was > 13% for at least five minutes. The patients were staged using the KDIGO (Kidney Disease: Improving Global Outcomes) criteria. The amount of bleeding during surgery was recorded for both groups.
No significant difference was observed in postoperative renal function. A significant difference was observed in the amount of intraoperative bleeding. The amount of bleeding was greater in patients managed with liberal fluid therapy. No significant difference was observed between the groups in the oral intake (hour), drain withdrawal (hour) mobilization (hour) and discharge (day) times and there isn't any statistically significant differance between groups in cost effectivity (p>0.05).
Kidney function was preserved during individualized targeted fluid therapy using non-invasive haemodynamic monitoring parameters.
在接受大型腹部手术的患者中，规划术中液体治疗非常重要。本研究旨在确定肾功能、出血和术后服务随访的液体治疗方案之间的差异。
这是一项观察性病例对照前瞻性研究。纳入 2023 年 12 月至 2023 年 2 月期间接受胰腺手术的 60 名年龄在 18-65 岁之间的患者。患者被分为两组：自由液体治疗组（第 1 组，n=30）和目标液体治疗组（第 2 组，n=30）。自由液体治疗计划以 8-10ml/kg/h 晶体液输注。目标液体治疗（TFT）组（第 2 组，n=30）以基线时 2ml/kg/h 的晶体液输注开始。如果 PVI 至少 5 分钟内超过 13%，则给予额外的 250ml 胶体液输注 10 分钟的液体冲击。根据 KDIGO（肾脏疾病：改善全球结局）标准对患者进行分期。记录两组患者术中出血量。
术后肾功能无显著差异。术中出血量有显著差异。采用自由液体治疗的患者术中出血量较大。两组患者的口服摄入（小时）、引流管拔出（小时）、活动（小时）和出院（天）时间无显著差异，且两组在成本效益方面无统计学差异（p>0.05）。
使用非侵入性血流动力学监测参数进行个体化目标液体治疗可保留肾功能。
