Perioperative fluids and complications after pancreatoduodenectomy within an enhanced recovery pathway.

Details

Serval ID
serval:BIB_1A7CC9E7E07D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Perioperative fluids and complications after pancreatoduodenectomy within an enhanced recovery pathway.
Journal
Scientific reports
Author(s)
Gilgien J., Hübner M., Halkic N., Demartines N., Roulin D.
ISSN
2045-2322 (Electronic)
ISSN-L
2045-2322
Publication state
Published
Issued date
21/10/2020
Peer-reviewed
Oui
Volume
10
Number
1
Pages
17898
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Optimized fluid management is a key component of enhanced recovery (ERAS) pathways. Implementation is challenging for pancreatoduodenectomy (PD) and clear guidance is missing in the respective protocol. The aim of this retrospective study was to evaluate the influence of perioperative intravenous (IV) fluid administration on postoperative complications. 164 consecutive patients undergoing PD within ERAS between October 2012 and June 2017 were included. Perioperative IV fluid and morbidity (Clavien classification and comprehensive complication index (CCI)) were assessed. A threshold of more than 4400 ml IV fluid during the first 24 h could be identified to predict occurrence of complications (area under ROC curve 0.71), with a positive and negative predictive value of 93 and 23% respectively. More than 4400 ml intravenous fluids during the first 24 h was an independent predictor of overall postoperative complications (adjusted odds ratio 4.40, 95% CI 1.47-13.19; p value = 0.008). Patients receiving ≥ 4400 ml were associated with increased overall complications (94 vs 77%; p value < 0.001), especially pulmonary complications (31 vs 16%; p value = 0.037), as well as a higher median CCI (33.7 vs 26.2; p value 0.041). This threshold of 4400 ml intravenous fluid might be a useful indicator for the management following pancreatoduodenectomy.
Pubmed
Web of science
Open Access
Yes
Create date
02/11/2020 13:49
Last modification date
25/11/2020 6:25
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