Feng-Ju Jia1, Qiao-Yuan Yan2, Qi Sun3, Tuerhongjiang Tuxun4, Hui Liu1, Li Shao5. 1. Central Operation Theatre, 1st Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan South Rd, Urumqi, Xinjiang, 830054, China. 2. Department of Nursery, The Union Hospital Affiliated Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430022, China. 3. Center of Medical Research and Data Processing, Xinjiang Chinese Medicine Hospital, Urumqi, Xinjiang, 830054, China. 4. Department of Liver and Laparoscopic Surgery, Center of Digestive and Vascular Surgery, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China. 5. Central Operation Theatre, 1st Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan South Rd, Urumqi, Xinjiang, 830054, China. shaoli9988@163.com.
Abstract
PURPOSE: This study compared perioperative restrictive fluid therapy to liberal (conventional) fluid therapy in patients undergoing major abdominal surgery and investigated the rate of post-operative morbidity (complication rates), recovery (time to flatus), and the length of hospital stay. METHODS: The Medline, PubMed, Cochrane, and EMBASE databases were searched until June 18, 2015. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in our analyses. A sensitivity analysis, publication bias assessment, and quality assessment were performed. RESULTS: The effects of the two therapies were similar in the subgroup analysis of patients who underwent hepato-gastroenterological surgery (P = 0.287). However, in a subgroup of patients who underwent vascular abdominal surgery, the restricted fluid treatment regimen was associated with a lower risk of complications in comparison with the conventional regimen (pooled OR = 0.12, 95 % CI 0.03-0.47, P = 0.002). There was no difference between the two regimens with respect to the incidence of cardiopulmonary complications (P = 0.733). However, the patients who received the restricted fluid treatment regimen had a shorter time to flatus (P = 0.031) and a shorter hospital stay (P = 0.033) than the patients who received the conventional regimen. CONCLUSIONS: Restrictive fluid therapy and liberal conventional therapy were associated with similar rates of overall and cardiopulmonary complications; however, restrictive fluid therapy was associated with a more rapid recovery and a shorter length of hospital stay.
PURPOSE: This study compared perioperative restrictive fluid therapy to liberal (conventional) fluid therapy in patients undergoing major abdominal surgery and investigated the rate of post-operative morbidity (complication rates), recovery (time to flatus), and the length of hospital stay. METHODS: The Medline, PubMed, Cochrane, and EMBASE databases were searched until June 18, 2015. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in our analyses. A sensitivity analysis, publication bias assessment, and quality assessment were performed. RESULTS: The effects of the two therapies were similar in the subgroup analysis of patients who underwent hepato-gastroenterological surgery (P = 0.287). However, in a subgroup of patients who underwent vascular abdominal surgery, the restricted fluid treatment regimen was associated with a lower risk of complications in comparison with the conventional regimen (pooled OR = 0.12, 95 % CI 0.03-0.47, P = 0.002). There was no difference between the two regimens with respect to the incidence of cardiopulmonary complications (P = 0.733). However, the patients who received the restricted fluid treatment regimen had a shorter time to flatus (P = 0.031) and a shorter hospital stay (P = 0.033) than the patients who received the conventional regimen. CONCLUSIONS: Restrictive fluid therapy and liberal conventional therapy were associated with similar rates of overall and cardiopulmonary complications; however, restrictive fluid therapy was associated with a more rapid recovery and a shorter length of hospital stay.
Entities:
Keywords:
Abdominal surgery; Fluid management; Liberal fluid; Meta-analysis; Restrictive fluid; Surgery
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