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The association between high-volume intraoperative fluid administration and outcomes among pediatric patients

Ethan L Sanford1, David Zurakowski1, Anna Litvinova1

  • 1Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston.

Paediatric Anaesthesia
|January 8, 2019
PubMed

Insights

High-volume fluid administration in pediatric colectomy patients is linked to longer hospital stays and slower recovery. Restrictive fluid strategies may improve outcomes for children undergoing bowel surgery.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Traditional fluid administration practices are being re-evaluated based on adult surgical data.
  • Limited research exists on the impact of fluid administration strategies in pediatric bowel surgery.

Purpose of the Study:

  • To investigate factors and outcomes associated with high-volume fluid administration in pediatric colectomy.
  • To test the hypothesis that high-volume fluid administration leads to impaired recovery and increased length of stay.

Main Methods:

  • Retrospective analysis of 209 pediatric colectomy encounters (July 2012-March 2017).
  • Stratification into high-volume (>90th percentile) and lower-volume fluid administration groups.
  • Statistical analysis including multivariable logistic regression and propensity score matching.

Main Results:

  • High-volume fluid administration was associated with increased length of stay (>6 days), delayed first meal (>4 days), and prolonged oxygen requirement (>24 hours).
  • Propensity score matched analysis confirmed these associations, showing significantly worse outcomes in the high-volume group.

Conclusions:

  • High-volume fluid administration in pediatric colectomy is linked to poorer postoperative recovery.
  • Findings suggest a need to reconsider fluid management strategies in pediatric bowel surgery.
Abstract

Keywords:
colorectal surgeryedemafluid therapylength of staypediatricpostoperative complications

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