Effects of Intraoperative Fluid Management on Postoperative Outcomes After Lobectomy

Area of Science:

• Thoracic Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• The optimal intraoperative fluid management for patients undergoing pulmonary resection remains a subject of debate.
• This study investigates the relationship between fluid administration and patient outcomes in minimally invasive lobectomy.

Purpose of the Study:

• To evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes.
• To determine the impact of total fluid and colloid infusion rates on complications after minimally invasive lobectomy.

Main Methods:

• Retrospective analysis of 446 adult patients undergoing minimally invasive lobectomy.
• Primary exposure variables: intraoperative total fluid and colloid infusion rates.
• Outcomes assessed: postoperative pulmonary complications (PPCs), acute kidney injury, mortality, length of stay, and costs.

Main Results:

• Restrictive, moderately liberal, and liberal total fluid infusion rates significantly increased PPC risk compared to moderate rates.
• No colloid and restrictive colloid infusion rates significantly increased PPC risk compared to moderate colloid rates.
• Both restrictive and liberal fluid strategies were linked to adverse postoperative outcomes.

Conclusions:

• Intraoperative fluid and colloid infusion rates are significantly associated with PPCs in minimally invasive lobectomy.
• Both restrictive and liberal fluid administration strategies negatively impact postoperative outcomes.