Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery: a randomised controlled pilot study (ISRCTN 11799696)

International Journal of Surgery
J HartenJ Kinsella

Abstract

Emergency abdominal surgery carries a high risk of postoperative morbidity and mortality. Goal directed therapy has been advocated to improve outcome in high-risk surgery. The aim of the present pilot study was to examine the effect of goal directed therapy using fluid alone on postoperative renal function and organ failure score in patients undergoing emergency abdominal surgery. This prospective randomised pilot study included patients over the age of 50 undergoing emergency abdominal surgery. In the intervention group pulse pressure variation measurements were used to guide fluid boluses of 6% Hydroxyethylstarch 130/0.4. The control group received standard care. Serum urea, creatinine and cystatin C levels were measured prior to and at the end of surgery and postoperatively on day 1, day 3 and day 5. Thirty patients were recruited. One patient died prior to surgery and was excluded from the analysis. The intervention group received a median of 750 ml of hydroxyethylstarch. The peak values of postoperative urea were 6.9 (2.7-31.8) vs. 6.4 (3.5-11.5)mmol/l (p=0.425), creatinine 100 (60-300) vs. 85 (65-150) micromol/l (p=0.085) and cystatin C 1.09 (0.66-4.94) vs. 1.01 (0.33-2.29)mg/dl (p=0.352) in the control and intervention g...Continue Reading

References

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Citations

Aug 8, 2012·Critical Care : the Official Journal of the Critical Care Forum·John R ProwleRinaldo Bellomo
May 16, 2013·Critical Care : the Official Journal of the Critical Care Forum·Maurizio CecconiAndrew Rhodes
Nov 3, 2015·The British Journal of Surgery·S H QureshiG J Murphy
Oct 29, 2014·Critical Care : the Official Journal of the Critical Care Forum·Jan BenesFrederic Michard
Nov 7, 2016·The Lancet Infectious Diseases·Benedetta AllegranziUNKNOWN WHO Guidelines Development Group
Oct 9, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Zoltán H Endre, John W Pickering
Jul 7, 2018·Acta Anaesthesiologica Scandinavica·Thomas KaufmannIwan C C van der Horst
Oct 10, 2018·Anesthesia and Analgesia·Antonio MessinaPaolo Navalesi
Sep 13, 2013·The Cochrane Database of Systematic Reviews·Mathew ZachariasNiamh P Conlon
Aug 16, 2014·Anesthesiology·Anne Sophie Pinholt KancirErling Bjerregaard Pedersen
Nov 2, 2012·Anesthesia and Analgesia·Philippe Van Der LindenRichard B Weiskopf
Jan 19, 2012·Anesthesia and Analgesia·Tomas CorcoranKwok M Ho
Aug 26, 2010·Anesthesia and Analgesia·Vanessa M BanzDaniel Inderbitzin
Apr 1, 2014·The Cochrane Database of Systematic Reviews·Marco VincetiCinzia Del Giovane
Feb 5, 2011·Current Opinion in Anaesthesiology·Mervyn Singer
Mar 8, 2019·World Journal of Gastrointestinal Surgery·Varut Lohsiriwat, Romyen Jitmungngan
Jun 28, 2019·Critical Care : the Official Journal of the Critical Care Forum·Mariateresa GiglioNicola Brienza
Aug 15, 2021·British Journal of Anaesthesia·Anne A AaenBirgitte Brandstrup

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