Perioperative medicine & outcomes
Ultrasound assessment of fluid tolerance in patients undergoing major gastrointestinal surgery: epidemiology of pulmonary and systemic congestion
Authors' conclusion
Reduced fluid tolerance detected by ultrasound is common after major gastrointestinal surgery and associated with increased LOS. Ultrasound assessments were technically feasible, but repeated assessments were perceived as a burden by a substantial proportion of patients.
Study context
- Population
- Patients undergoing major gastrointestinal surgeryparticipants included
- Participants
- 200 patients
- Outcome
- Prevalence of reduced fluid tolerance
- Follow-up
- Before surgery and daily for up to 5 days after surgery
Main finding
As reported in the abstract
Participants with signs of reduced fluid tolerance
73
37%
Most common on postoperative day 4
n=28; 14%
Pulmonary congestion, of the 73 with reduced fluid tolerance
n=69; 95%
Reduced fluid tolerance limited to 1 day, of the 73 affected patients
47 of 73; 64%
Observational data: associations, not effects.
Secondary outcomes
Length of stay (LOS) of >7 days
| Odds ratio (95% CI) | ||
|---|---|---|
| Reduced fluid tolerance | 3.29 (1.03–10.70) | |
| 0.050.21520Odds ratio (log scale) |
Major postoperative complications (Clavien-Dindo grade ≥3)
| Hazard ratio (95% CI) | ||
|---|---|---|
| Reduced fluid toleranceNot associated | 1.18 (0.49–2.86) | |
| 0.20.5125Hazard ratio (log scale) |
Feasibility of ultrasound assessments (missing assessments)
- Missing of 1200 planned assessments
- 146 (12%)
- Missing because participants declined, mostly owing to the burden of repeated assessments
- 123
- Missing because of incomplete views
- 23 (2%)
Original publication
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