BACKGROUND: Fluid management is a fundamental component of surgical care. Recently, there has been considerable interest in perioperative fluid restriction as a method of facilitating recovery following elective major surgery. A number of randomized trials have addressed the issue in various surgical specialities, and a recent meta-analysis proposed uniform definitions regarding fluid amount as well as examining fluid restriction in patients undergoing colonic resection. METHODS: Medline, Embase, trial registries, conference proceedings, and article reference lists were searched to identify randomized, controlled trials of perioperative fluid restriction versus "standard" perioperative fluid management, as per definitions formulated previously. All of the studies involved patients undergoing colonic resection. The primary outcome measure was postoperative morbidity. Secondary endpoints included mortality, renal failure, time to first flatus, and length of hospital stay. A random effects model was applied. RESULTS: Seven randomized, controlled trials with a total of 856 patients investigating standard versus restrictive fluid regimes, as denoted by the definitions, were included. Perioperative fluid restriction had no effect on the risk of postoperative complications (OR 0.49 (95 % confidence interval (CI) 0.2-1.18; P = 0.101). There was no detectable effect on death and fluid restriction did not reduce hospital stay (Pooled weighted mean difference -0.25; 95 % CI 0.72-0.21; P = 0.29). CONCLUSIONS: Perioperative fluid restriction does not significantly reduce the risk of complications following major abdominal surgery. Furthermore, it does not appear to reduce length of hospital stay.
BACKGROUND: Fluid management is a fundamental component of surgical care. Recently, there has been considerable interest in perioperative fluid restriction as a method of facilitating recovery following elective major surgery. A number of randomized trials have addressed the issue in various surgical specialities, and a recent meta-analysis proposed uniform definitions regarding fluid amount as well as examining fluid restriction in patients undergoing colonic resection. METHODS: Medline, Embase, trial registries, conference proceedings, and article reference lists were searched to identify randomized, controlled trials of perioperative fluid restriction versus "standard" perioperative fluid management, as per definitions formulated previously. All of the studies involved patients undergoing colonic resection. The primary outcome measure was postoperative morbidity. Secondary endpoints included mortality, renal failure, time to first flatus, and length of hospital stay. A random effects model was applied. RESULTS: Seven randomized, controlled trials with a total of 856 patients investigating standard versus restrictive fluid regimes, as denoted by the definitions, were included. Perioperative fluid restriction had no effect on the risk of postoperative complications (OR 0.49 (95 % confidence interval (CI) 0.2-1.18; P = 0.101). There was no detectable effect on death and fluid restriction did not reduce hospital stay (Pooled weighted mean difference -0.25; 95 % CI 0.72-0.21; P = 0.29). CONCLUSIONS: Perioperative fluid restriction does not significantly reduce the risk of complications following major abdominal surgery. Furthermore, it does not appear to reduce length of hospital stay.
Authors: Dileep N Lobo; Kate A Bostock; Keith R Neal; Alan C Perkins; Brian J Rowlands; Simon P Allison Journal: Lancet Date: 2002-05-25 Impact factor: 79.321
Authors: Andrew L Tambyraja; Fergus Sengupta; Alasdair B MacGregor; David C C Bartolo; Kenneth C H Fearon Journal: World J Surg Date: 2004-09-29 Impact factor: 3.352
Authors: Barbara Kabon; Ozan Akça; Akiko Taguchi; Angelika Nagele; Ratnaraj Jebadurai; Cem F Arkilic; Neeru Sharma; Arundhathi Ahluwalia; Susan Galandiuk; James Fleshman; Daniel I Sessler; Andrea Kurz Journal: Anesth Analg Date: 2005-11 Impact factor: 6.627
Authors: Mikaela L Garland; Hamish S Mace; Andrew D MacCormick; Stuart A McCluskey; Nicholas J Lightfoot Journal: J Gastrointest Surg Date: 2019-01-22 Impact factor: 3.452
Authors: M R Boland; I Reynolds; N McCawley; E Galvin; S El-Masry; J Deasy; D A McNamara Journal: Ann R Coll Surg Engl Date: 2016-09-23 Impact factor: 1.891
Authors: Brian P Chen; Marian Chen; Sean Bennett; Kristina Lemon; Kimberly A Bertens; Fady K Balaa; Guillaume Martel Journal: World J Surg Date: 2018-09 Impact factor: 3.352
Authors: Matthew W Semler; Arthur P Wheeler; B Taylor Thompson; Gordon R Bernard; Herbert P Wiedemann; Todd W Rice Journal: Crit Care Med Date: 2016-04 Impact factor: 7.598