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[Intraoperative fluid management in pancreatic resections--the surgeon's view]
N Lindenblatt1, S Park, G Alsfasser
1Abteilung für Allgemeine Chirurgie, Thorax-, Gefäss- und Transplantationschirurgie, Universität Rostock, Rostock. niclindenblatt@hotmail.com
Zentralblatt Fur Chirurgie
|April 17, 2008
Summary
Intraoperative fluid management in major abdominal surgery, specifically pancreas resections, shows no negative impact on outcomes with fluid volumes of 10-15 mL/kg/h. This evidence supports targeted fluid therapy for improved patient recovery.
Area of Science:
- Surgical Oncology
- Anesthesiology
- Critical Care Medicine
Background:
- Intraoperative fluid management is crucial in major abdominal surgery.
- Evidence-based recommendations for fluid therapy from a surgeon's perspective are lacking.
- Surgeons are interested in fluid impact on wound healing, bleeding, and postoperative outcomes.
Purpose of the Study:
- To define optimal perioperative fluid regimes for major intraabdominal surgery from a surgical viewpoint.
- To evaluate the influence of intraoperative fluid administration on surgical outcomes.
Main Methods:
- Retrospective analysis of 98 pancreas resections.
- Evaluation of intraoperative fluid amounts administered.
- Assessment of postoperative complications including bleeding, wound infection, and pancreatic fistula.
Main Results:
- No significant differences in postoperative bleeding, wound infection, or pancreatic fistula rates were observed based on intraoperative fluid amounts.
- Average intraoperative fluid infusion was 13.9 mL/kg/h.
- Catecholamines and noradrenaline were frequently administered.
Conclusions:
- Intraoperative fluid volumes of 10-15 mL/kg/h do not negatively affect outcomes in pancreas resections.
- Intraoperative fluid therapy should be targeted within this range for pancreas resections.