From: Perioperative changes in fluid distribution and haemodynamics in acute high-risk abdominal surgery
Variables | Intestinal obstruction (n = 27) | Perforated viscus (n = 26) | Anastomotic leakage (n = 20) | P value (chi-square) |
---|---|---|---|---|
Baseline, n (%) | ||||
Age, years, range | 64 (27–90) | 67.5 (22–87) | 60 (25–80) | 0.598† |
Female | 13 (48.1) | 13 (50.0) | 8 (40.0) | 0.780 |
BMI, kg/m2, median (IQR) | 25 (22–32) | 26 (20–30) | 28 (22–32) | 0.239 |
ASA score > II | 10 (37.3) | 11 (42.3) | 6 (30.0) | 0.692 |
ECOG performance score > 1 | 12 (44.5) | 14 (53.8) | 6 (30.0) | 0.270 |
Charlson Comorbidity Index ≥ 3 | 16 (59.2) | 14 (53.8) | 12 (60.0) | 0.893 |
qSOFA, > 1 | 1 (3.7) | 3 (11.5) | 7(35.0) | 0.010 |
Comorbidities, n (%) | ||||
Cardiovascular | 7 (25.9) | 9 (34.6) | 5 (25.0) | 0.712 |
Ischemic heart disease | 1 (3.7) | 2 (7.7) | 0 (0.0) | 0.710 |
Congestive heart failure | 1 (3.7) | 2 (7.7) | 1 (5.0) | 0.700 |
Pulmonary | 4 (14.8) | 3 (11.5) | 2 (10.0) | 0.811 |
Cerebrovascular | 2 (7.4) | 2 (7.7) | 0 (0.0) | 0.449 |
Renal | 1 (3.7) | 3 (11.5) | 2 (10.0) | 0.551 |
Diuretics | 3 (11.1) | 5 (19.2) | 4 (20.0) | 0.284 |
Preoperative blood samples, median (IQR) | ||||
Plasma albumin, g/L | 35 (28–41) | 30 (25–36) | 26 (22–27) | < .001 |
C-reactive protein, mg/dL | 10 (5–10) | 70 (10–210) | 320 (250–355) | < .0001 |
Creatinine, mmol/L | 78 (62–92) | 82 (68–124) | 87 (68–94) | 0.456 |
Plasma sodium, mmol/L | 137 (134–139) | 136 (135–139) | 136 (134–139) | 0.052 |
Plasma potassium, mmol/L | 3.9 (3.6–4.0) | 3.6 (3.5–4.2) | 3.8 (3.6–4.1) | 0.165 |
Plasma chloride, mmol/L | 102 (99–106) | 106 (102–108) | 104 (101–107) | 0.257 |
Plasma lactate, mmol/L | 0.8 (0.7–1.8) | 1.2 (0.8–1.9) | 1.1 (0.8–1.7) | 0.379 |
Intraoperative parameters, n (%) | ||||
Laparoscopy | 2 (7.4) | 8 (30.8) | 7 (35.0) | 0.029 |
Laparotomy | 25 (92.6) | 18 (69.2) | 13 (65.0) | 0.029 |
Epidural analgesia | 20 (74.1) | 24 (92 | 18 890.0) | 0.199 |
Vasopressor infusion* | 14 (51.8) | 18 (69.2) | 17 (85.0) | 0.050 |
Manheim Peritonitis Index > 20 | 7 (26.0) | 14 (53.8) | 8 (40.0) | 0.116 |
Volume Status Evaluation, median (IQR) | ||||
Intraoperative fluid balance, L | 1.8 (1.4–2.1) | 1.9 (1.5–2.6) | 1.6 (1.2–2.2) | 0.340¤ |
Crystalloids, L | 1.0 (0.7–1.9) | 1.3 (1.0–1.6) | 1.1 (0.8–1.3) | 0.352¤ |
Colloids, L | 0.5(0.4–0.8) | 0.8 (0.5–1.3) | 0.5 (0.4–0.8) | 0.230¤ |
Cumulated I/O, L, days 1–5 | 3.4 (1.1–11.4) | 6.9 (3.0–11.5) | 1.3 (− 3.1–6.8) | 0.014¤ |
Cumulated crystalloids, L, days 1–5 | 5.1 (4.2–9.9) | 6.6 (4.5–10.1) | 8.6 (5.7–11.2) | 0.200¤ |
Cumulated colloids, L, days 1–5 | 0.0 (0.0–0.8) | 0.3 (0.0–0.7) | 0.1 (0.0–0.5) | 0.610¤ |
Body weight change, kg: days 1–5 | 2.7 (− 1.5–6.0) | 4.5 (1.0–8.1) | 1.2 (− 1.2–2.3) | 0.152¤ |
AFO volume change, L: days 1–5 | 3.35 (1.40–5.20) | 5.15 (3.90–5.80) | 3.50 (1.75–4.50) | 0.044¤ |