- Poster presentation
- Open access
- Published:
Excessive fluid balance effect in mortality rate from surgical patients
Critical Care volume 17, Article number: P57 (2013)
Introduction
In some studies including small populations of patients undergoing gastrointestinal surgery, a liberal infusion of fluids during the intraoperative period was associated with increased morbidity when compared with restrictive strategies for volume replacement. However, there are few studies evaluating the role of excessive fluid infusion in a population of high-risk surgical patients intraoperatively. The aim of this study was to evaluate the impact of the excessive water balance in the perioperative morbidity and mortality of high-risk surgical patients.
Methods
A prospective cohort study during 1 year in four ICUs from three tertiary hospitals. The study included patients who required postoperative ICU, aged ≥18 years undergoing major surgery. Patients with palliative surgery were excluded. The calculation from fluid balance was based on the surgical duration, the time of fasting preoperative and intraoperative, urine output and fluid replacement intraoperatively.
Results
The study included 479 patients. Mean age was 61.2 ± 17.0 years and 51.1% were men. Nonsurvivors in the hospital represented 8.8% of patients. The median duration of surgery was 4.0 (3.2 to 5.5) hours. The average value of the SAPS 3 score was 41.8 ± 14.5 and ASA II was 52.8%. However, when comparing survivors and nonsurvivors, the fluid balance intraoperatively from nonsurvivors was higher (1,950 (1,400 to 3,400) ml vs. 1,400 (1,000 to 1,600) ml, P <0.001), patients with fluid balance above 2,000 ml intraoperatively had longer ICU stay (4.0 (3.0 to 8.0) vs. 3.0 (2.0 to 6.0), P = 0.000) and higher incidence of infectious complications (41.9% vs. 25.9%, P = 0.001), neurological (46.2% vs. 13.2%, P = 0.000), cardiovascular (63.2% vs. 39.6%, P = 0.000) and respiratory (34.3% vs. 11.6%, P = 0.000). In multivariate analysis, the fluid balance was an independent factor for death (OR = 1.002, P = 0.04, 95% CI = 1.001 to 1.004). See Table 1.
Conclusion
Patients with excessive fluid balance intraoperatively have more ICU complications and higher hospital mortality.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Silva, J., Nogueira, F., Vianna, P. et al. Excessive fluid balance effect in mortality rate from surgical patients. Crit Care 17 (Suppl 3), P57 (2013). https://doi.org/10.1186/cc12673
Published:
DOI: https://doi.org/10.1186/cc12673