Intraoperative fluid therapy and pulmonary complications

The purpose of this study was to evaluate the effects of intraoperative fluid therapy on length of hospital stay and pulmonary complications in patients undergoing spine surgery. A total of 1307 patients were analyzed. Sixteen pulmonary complications were observed. Patients with a higher volume of administered crystalloids, colloids, and total intravenous fluids were more likely to have postoperative respiratory complications: the odds of postoperative respiratory complications increased by 30% with an increase of 1000 mL of crystalloid administered. The best cutoff point for total fluids was 4165 mL, with a sensitivity of 0.8125 and specificity of 0.7171, for postoperative pulmonary complications. A direct correlation existed between fluids and length of stay: patients who received >4165 mL of total fluids had an average length of stay of 3.88±4.66 days vs 2.3±3.9 days for patients who received <4165 mL of total fluids (P<.0001). This study should be considered as hypothesis-generating to design a prospective trial comparing high vs low intraoperative fluid regiments for patients undergoing spine surgery.