Analysis of complications that occurred in the perioperative period, when using different modes of fluid therapy

Authors

  • Sergii Kursov Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176, Ukraine
  • Kseniia Lyzohub SE “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine” Pushkinska str., 80, Kharkiv, Ukraine, 61024, Ukraine
  • Mykola Lyzohub SI “Sytenko Institute of Spine and Joint Pathology AMS of Ukraine” Pushkinskaya street, 80, Kharkiv, Ukraine, 61024, Ukraine

DOI:

https://doi.org/10.15587/2519-4798.2017.113527

Keywords:

restrictive fluid resuscitation, purposeful fluid therapy, hemodynamics, vasopressors, hypovolemia, organ perfusion

Abstract

Aim: To realize the clinical analysis of post-surgical complications in patients, who received intraoperative infuse therapy by the method of the restrictive mode of fluid resuscitation and purposeful fluid therapy for providing the adequate and stable hemodynamics in perioperative period and also for preventing the complications development.

Materials and methods: the study was realized in 176 patients, who underwent surgical interventions in orthopedic oncology. The restrictive mode of fluid resuscitation was applied in 88 cases, and in 88 ones – the purposeful fluid therapy. The central hemodynamics was studied by the method of Cubichek tetrapolar rheography, coagulogram indications, dieresis speed, blood serum creatinine, frequency of postoperative nausea and vomit and enteroparesis were studied.

Research results: the frequency of coagulopathy observations at purposeful fluid therapy didn’t reliably exceed the frequency of coagulopathy in patients with the restrictive mode. Patients, who underwent purposeful fluid therapy demonstrated the decrease of dieresis speed, postoperative nausea and vomit and enteroparesis reliably more seldom. At providing purposeful fluid therapy, there was observed the more stable hemodynamics, whereas patients with the restrictive mode of resuscitation reliably more often needed for the additional hemodynamic correction, which needed the use of vasopressors in 67 % of cases and unplanned increase of infusion therapy volume in 36 % of cases.

Conclusions: the risk of complications of GIT and kidneys decreases at using purposeful fluid therapy, and the more stable postoperative hemodynamics comparing with the restrictive mode is guaranteed

Author Biographies

Sergii Kursov, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor

Department of Critical Care Medicine, Disaster Medicine and Military Medicine

Kseniia Lyzohub, SE “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine” Pushkinska str., 80, Kharkiv, Ukraine, 61024

Junior Researcher

Department of Bone Oncology 

Mykola Lyzohub, SI “Sytenko Institute of Spine and Joint Pathology AMS of Ukraine” Pushkinskaya street, 80, Kharkiv, Ukraine, 61024

Candidate of Medical Sciences

Head of Department of Anaesthesiology and Intensive Therapy

References

  1. Butler, F. K., Holcomb, J. B., Schreiber, M. A. et. al. (2015). Liquid resuscitation in case of hemorrhagic shock in the Manual for first aid in combat conditions by unqualified personnel. Medicine of non-adherence to the countries, 3, 56–83.
  2. Dutton, R. P. (2014). Management of traumatic haemorrhage – the US perspective. Anaesthesia, 70, 108–e38. doi: 10.1111/anae.12894
  3. Gutierrez, M. C., Moore, P. G., Liu, H. (2013). Goal-Directed Therapy in Intraoperative Fluidand Hemodynamic Management. Journal of Biomedical Research, 27 (5), 357–365. doi: 10.7555/JBR.27.20120128
  4. Cata, J. P., Gottumukkala, V. (2012). Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know? ISRN Anesthesiology, 2012, 1–11. doi: 10.5402/2012/918938
  5. Veelo, D. P., van Berge Henegouwen, M. I., Ouwehand, K. S., Geerts, B. F., Anderegg, M. C. J., van Dieren, S. et. al. (2017). Effect of goal-directed therapy on outcome after esophageal surgery: A quality improvement study. PLOS ONE, 12 (3), e0172806. doi: 10.1371/journal.pone.0172806
  7. Voldby, A. W., Brandstrup, B. (2016). Fluid therapy in the perioperative setting–a clinical review. Journal of Intensive Care, 4 (1), 27. doi: 10.1186/s40560-016-0154-3
  9. Pang, Q., Liu, H., Chen, B., Jiang, Y. (2017). Restrictive and liberal fluid administration in major abdominal surgery. Saudi Medical Journal, 38 (2), 123–131. doi: 10.15537/smj.2017.2.15077
  10. Kaur, M., Anjum, A., Soni, K., Kumar, A., Albert, V., Sawhney, C., Subramanian, A. (2013). Assessment of hemostatic changes after crystalloid and colloid fluid preloading in trauma patients using standard coagulation parameters and thromboelastography. Saudi Journal of Anaesthesia, 7 (1), 48–56. doi: 10.4103/1658-354x.109809
  11. Doherty, M., Buggy, D. J. (2012). Intraoperative fluids: how much is too much? British Journal of Anaesthesia, 109 (1), 69–79. doi: 10.1093/bja/aes171
  12. Kozek-Langenecker, S. A., Afshari, A., Albaladejo, P., Santullano, C. A. A., De Robertis, E., Filipescu, D. C. et. al. (2013). Management of Severe Perioperative Bleeding: Guidelines from the European Society of Anaesthesiology. European Journal of Anaesthesiology, 30 (6), 270–382. doi: 10.1097/eja.0b013e32835f4d5b
  13. Rossaint, R., Bouillon, B., Cerny, V., Coats, T. J., Duranteau, J., Fernandez-Mondejar, E. et. al. (2016). The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Critical Care, 20 (1), 100. doi: 10.1186/s13054-016-1265-x

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Published

2017-10-31

How to Cite

Kursov, S., Lyzohub, K., & Lyzohub, M. (2017). Analysis of complications that occurred in the perioperative period, when using different modes of fluid therapy. ScienceRise: Medical Science, (10 (18), 55–58. https://doi.org/10.15587/2519-4798.2017.113527

Issue

No. 10 (18) (2017)

Section

Medical Science

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Copyright (c) 2017 Mykola Lyzohub, Sergii Kursov, Kseniia Lyzohub

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