1. Observational study on fluid therapy management in surgical adult patients
- Author
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Maria J. Colomina, Javier Ripollés-Melchor, Patricia Guilabert, José Luis Jover, Misericordia Basora, Concha Cassinello, Raquel Ferrandis, Juan V. Llau, Judith Peñafiel, Institut Català de la Salut, [Colomina MJ] Department of Anesthesia, Critical care and Pain Clinic, Hospital Universitari de Bellvitge, Barcelona, Spain. Barcelona University, Barcelona, Spain. Bellvitge Research Institute, IDIBELL, Barcelona, Spain. [Ripollés-Melchor J] Department of Anaesthesia, Hospital Universitario Infanta Leonor, Madrid, Spain. [Guilabert P] Servei d’Anestèsia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Jover JL] Department of Anaesthesia, Hospital Verge dels Lliris, Alcoi, Alicante, Spain. [Basora M] Department of Anaesthesia, Hospital Clínic, Barcelona, Spain. [Cassinello C] Department of Anaesthesia, Hospital Universitario Miguel Servet, Zaragoza, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,Therapeutics::Patient Care::Perioperative Care [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Therapeutics::Drug Therapy::Fluid Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,terapéutica::asistencia al paciente::asistencia periquirúrgica [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Perioperative Care ,Practice guidelines ,Postoperative care ,Balanced crystalloids ,Fluid therapy ,Surgical procedures ,Hemodynamic monitoring ,Anesthesiology ,Humans ,RD78.3-87.3 ,Fluidoteràpia ,Health Occupations::Medicine::Anesthesiology [DISCIPLINES AND OCCUPATIONS] ,Aged ,terapéutica::farmacoterapia::fluidoterapia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Fluid therapy management ,Terapèutica quirúrgica ,Research ,Liquids ,Middle Aged ,Líquids ,profesiones sanitarias::medicina::anestesiología [DISCIPLINAS Y OCUPACIONES] ,Cura postoperatòria ,Cross-Sectional Studies ,Anesthesiology and Pain Medicine ,Spain ,Anestesiologia ,Female - Abstract
Background Perioperative fluid therapy management is changing due to the incorporation of different fluids, surgical techniques, and minimally invasive monitoring systems. The objective of this study was to explore fluid therapy management during the perioperative period in our country. Methods We designed the Fluid Day study as a cross-sectional, multicentre, observational study. The study was performed in 131 Spanish hospitals in February 2019. We included adult patients undergoing general anaesthesia for either elective or non-elective surgery. Demographic variables were recorded, as well as the type and total volume of fluid administered during the perioperative period and the monitorization used. To perform the analysis, patients were categorized by risk group. Results We recruited 7291 patients, 6314 of which were included in the analysis; 1541 (24.4%) patients underwent high-risk surgery, 1497 (23. 7%) were high risk patients, and 554 (8.7%) were high-risk patients and underwent high-risk surgery; 98% patients received crystalloids (80% balanced solutions); intraoperative colloids were used in 466 patients (7.51%). The hourly intraoperative volume in mL/kg/h and the median [Q1; Q3] administered volume (mL/kg) were, respectively, 6.67 [3.83; 8.17] ml/Kg/h and 13.9 [9.52;5.20] ml/Kg in low-risk patients undergoing low- or intermediate-risk surgery, 6 [4.04; 9.08] ml/Kg/h and 15.7 [10.4;24.5] ml/Kg in high- risk patients undergoing low or intermediate-risk surgery, 6.41 [4.36; 9.33] ml/Kg/h and 20.2 [13.3;32.4] ml/Kg in low-risk patients undergoing high-risk surgery, and 5.46 [3.83; 8.17] ml/Kg/h and 22.7[14.1;40.9] ml/Kg in high-risk patients undergoing high- risk surgery . We used advanced fluid monitoring strategies in 5% of patients in the intraoperative period and in 10% in the postoperative period. Conclusions The most widely used fluid was balanced crystalloids. Colloids were used in a small number of patients. Hourly surgery volume tended to be more restrictive in high-risk patients but confirms a high degree of variation in the perioperatively administered volume. Scarce monitorization was observed in fluid therapy management. Trial registration Clinical Trials: NCT03630744.
- Published
- 2021