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

Détails

ID Serval
serval:BIB_1A7CC9E7E07D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Perioperative fluids and complications after pancreatoduodenectomy within an enhanced recovery pathway.
Périodique
Scientific reports
Auteur(s)
Gilgien J., Hübner M., Halkic N., Demartines N., Roulin D.
ISSN
2045-2322 (Electronic)
ISSN-L
2045-2322
Statut éditorial
Publié
Date de publication
21/10/2020
Peer-reviewed
Oui
Volume
10
Numéro
1
Pages
17898
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
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
Oui
Création de la notice
02/11/2020 13:49
Dernière modification de la notice
25/11/2020 6:25
Données d'usage