The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial
Abdelrahman, K., Sayed, J., Seddik, M., Thabet, A., AbdelNaser, M. (2023). The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial. EKB Journal Management System, 6(2), 169-180. doi: 10.21608/svuijm.2023.178375.1462
Khaled Abdelbaky Abdelrahman; Jehan A Sayed; Mohamed I. Seddik; Amr M. Thabet; Mohamed Abdallah AbdelNaser. "The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial". EKB Journal Management System, 6, 2, 2023, 169-180. doi: 10.21608/svuijm.2023.178375.1462
Abdelrahman, K., Sayed, J., Seddik, M., Thabet, A., AbdelNaser, M. (2023). 'The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial', EKB Journal Management System, 6(2), pp. 169-180. doi: 10.21608/svuijm.2023.178375.1462
Abdelrahman, K., Sayed, J., Seddik, M., Thabet, A., AbdelNaser, M. The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial. EKB Journal Management System, 2023; 6(2): 169-180. doi: 10.21608/svuijm.2023.178375.1462

The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial

SVU-International Journal of Medical Sciences
Article 15, Volume 6, Issue 2, July 2023, Page 169-180  XML PDF (411.43 K)
Document Type: Original research articles
DOI: 10.21608/svuijm.2023.178375.1462
View on SCiNiTO View on SCiNiTO
Authors
Khaled Abdelbaky Abdelrahman1; Jehan A Sayed1; Mohamed I. Seddik2; Amr M. Thabet1; Mohamed Abdallah AbdelNaser email orcid 1
1Department of Anesthesia, Intensive Care and Pain Management Faculty of Medicine, Assiut University, Assiut, Egypt.
2Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
Abstract
Background: intraoperative fluid handling has a lot of concerns upon the postoperative organ function. One of the most sensitive organs which could be affected is the kidney.
Objectives:  We conducted this trial to address the impact of restrictive vs. conservative fluid approaches on postoperative renal complications, hemodynamics and hospital stay.
Patients and methods: Prospective, randomized, double-blind placebo-controlled trial at Assiut University Hospitals.  The study included 60 adult patients with American Society of Anesthesiologists (ASA) grade II-III undergoing elective colorectal surgery with an expected operative duration of at least two hours. Grouping was based upon the intraoperative fluid management Group (R): 6 mL/kg/h. of lactated ringer (LR), Group (C): 12 mL/kg/h. of LR. The preoperative serum Neutrophil gelatinase-associated lipocalin (NGAL) level (basal value) then by the 2nd and 24th postoperative hours, KDIGO (Kidney Disease: Improving Global Outcomes), serum urea and creatinine were documented by the end of 1st and 2nd postoperative days. Intraoperative hypovolemia events were noted as well.
Results: serum NGAL has increased >149 ng/mlin three patients within group C, and two patients within group R; however, the difference was statistically insignificant p= 0.5. KDIGO showed significant difference between the two groups, with higher number of patients in the group R with p= 0.043. Serum urea and creatinine, intraoperative hypovolemic episodes showed insignificant differences between groups.
Conclusion: no evident difference between restrictive and conservative intraoperative fluid strategies was noticed upon the early postoperative serum NGAL and other systems complications in patients undergoing major colorectal surgeries.
Keywords
Intraoperative; Fluid strategies; Renal outcome
Statistics
Article View: 269
PDF Download: 238