Dehydration and fluid volume kinetics before major open abdominal surgery

2014 ◽  
Vol 58 (10) ◽  
pp. 1258-1266 ◽  
Author(s):  
R. G. HAHN ◽  
H. BAHLMANN ◽  
L. NILSSON
Keyword(s):  
Abdominal Surgery ◽  
Fluid Volume ◽  
Open Abdominal Surgery ◽  
Volume Kinetics

scholarly journals The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guido Mazzinari ◽  
◽  
Ary Serpa Neto ◽  
Sabrine N. T. Hemmes ◽  
Goran Hedenstierna ◽  
...  
Keyword(s):  
Propensity Score ◽  
Adverse Events ◽  
Abdominal Surgery ◽  
Las Vegas ◽  
Cohort Analysis ◽  
Risk Difference ◽  
Pulmonary Complications ◽  
Driving Pressure ◽  
Postoperative Pulmonary Complications ◽  
Open Abdominal Surgery

Abstract Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P <  0.001 versus 1.05 [95%CI 1.05 to 1.05], P <  0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P <  0.001). The association of ΔPTW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12– to 1.14], P <  0.001 versus 1.07 [95%CI 1.05 to 1.10], P <  0.001; risk difference 0.05 [95%CI 0.030.07], P <  0.001). Conclusions ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. Trial registration LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

scholarly journals Association between Blood Potassium Level and Recovery of Postoperative Gastrointestinal Motility during Continuous Renal Replacement Therapy in Patient Undergoing Open Abdominal Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yi Yang ◽  
Jingjuan Yang ◽  
Xiner Yao ◽  
Yu Cui ◽  
Xiabing Lang ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Gastrointestinal Motility ◽  
Potassium Level ◽  
Potassium Concentration ◽  
Binary Logistic Regression ◽  
Plasma Potassium ◽  
Postoperative Recovery ◽  
Binary Logistic Regression Model ◽  
Open Abdominal Surgery ◽  
Blood Potassium

Background. The aim of this study was to identify the blood potassium level beneficial to the postoperative recovery of gastrointestinal motility during continuous renal replacement therapy (CRRT) in patient undergoing open abdominal surgery. Materials and Methods. 538 critically ill patients after open abdominal surgery and receiving CRRT were retrospectively recruited as the study cohort. Demographic and clinical data were recorded along with an evaluation of the postoperative gastrointestinal motility. Results. Correlation analysis was used to assess the correlation coefficient, and then the variables with correlation coefficient value less than 0.5 were included in the binary logistic regression model. Binary logistic regression model indicated that the postoperative blood potassium level was independently associated with the recovery of gastrointestinal motility (OR=0.109, 95% CI= 0.063 to 0.190, p<0.001). Based on the normal range of blood potassium level, we selected the cut-off point of blood potassium level via Weight of Evidence analysis, which was 4.00 mmol/L. Compared with the patients with insufficient blood potassium levels (plasma potassium concentration < 4.00 mmol/L), those with sufficient blood potassium levels (plasma potassium concentration≥ 4.00 mmol/L) conferred an increase in the rate of 4-day postoperative recovery of gastrointestinal motility (OR= 4.425, 95% CI = 2.933 to 6.667, p<0.001). Conclusions. Maintaining the blood potassium concentrations at a relatively high level of the normal blood potassium range during CRRT would be beneficial to postoperative recovery of gastrointestinal motility.

scholarly journals Dezocine Prevents Postoperative Hyperalgesia in Patients Undergoing Open Abdominal Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Fang Yu ◽  
Jie Zhou ◽  
Suyun Xia ◽  
Huan Xu ◽  
Xiangrui Wang
Keyword(s):  
Treatment Group ◽  
Abdominal Surgery ◽  
Pain Threshold ◽  
Controlled Trial ◽  
Thermal Hyperalgesia ◽  
Postoperative Nausea And Vomiting ◽  
Open Gastrectomy ◽  
Sham Treatment ◽  
Pain Scores ◽  
Open Abdominal Surgery

Objective. Postoperative hyperalgesia is very frequent and hard to treat. Dezocine is widely used and has a modulatory effect for thermal hyperalgesia in animal models. So, this study was designed to investigate the potential role of dezocine in decreasing postoperative hyperalgesia for patients undergoing open abdominal surgery.Methods. This is a randomized, double-blinded, and placebo-controlled trial. 50 patients for elective open gastrectomy were randomly allocated to either a true treatment group (0.15 mg/kg intravenous dezocine at the end of surgery) or a sham treatment group (equivalent volume of saline) in a 1 : 1 ratio. Patients were followed up for 48 hours postoperatively and pain threshold to Von Frey filaments, pain scores, PCIA consumption, rescue analgesics use, sedation score, and occurrence of postoperative nausea and vomiting were recorded.Results. Patients in the true treatment group experienced statistically significantly higher pain threshold on forearm and smaller extent of peri-incisional hyperalgesia than the sham treatment group. Rescue analgesic use, cumulative PCIA consumption, and pain scores were statistically significantly decreased in the true treatment group compared to the sham treatment group.Conclusions. Dezocine offers a significant antihyperalgesic and analgesic effect in patients undergoing elective open gastrectomy for up to 48 hours postoperatively.

Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis

2016 ◽  
Vol 40 (10) ◽  
pp. 2319-2330 ◽  
Author(s):  
Julia B. Kössler-Ebs ◽  
Kathrin Grummich ◽  
Katrin Jensen ◽  
Felix J. Hüttner ◽  
Beat Müller-Stich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Incisional Hernia ◽  
Meta Analysis ◽  
Open Abdominal Surgery

The impact of previous open abdominal surgery on the outcome of laparoscopic colorectal surgery

2021 ◽  
Vol 28 (12) ◽  
pp. 2122
Author(s):  
Ismail Eray ◽  
Ugur Topal ◽  
Orcun Yalav ◽  
Kubilay Dalci ◽  
Ahmet Saritas ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Abdominal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Open Abdominal Surgery ◽  
The Impact

Circular pOlyethylene drape in preVEntion of suRgical site infection (COVER Trial): Study protocol of a randomized controlled trial

2018 ◽  
Author(s):  
Ri Na Yoo ◽  
Hyung Jin Kim ◽  
Jae Im Lee ◽  
Won-Kyung Kang ◽  
Bong-Hyeon Kye ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Controlled Trial ◽  
Dropout Rate ◽  
Site Infection ◽  
Gi Tract ◽  
Randomized Controlled ◽  
Wound Protector ◽  
Open Abdominal Surgery

Abstract Background: Surgical site infection (SSI) after abdominal surgery is still a significant morbidity associated with an increased socioeconomic burden and poor quality of life. SSI prevalence rates as high as 40% in cases of fecal contamination have been reported; however, current methods to reduce SSI are limited to elective abdominal surgery. Further evaluation of preventive measures for reducing SSI is necessary. Methods/design: The COVER trial investigates whether the application of a dual-ring circular plastic wound protector reduces the rate of SSI in patients undergoing open abdominal surgery related to the gastrointestinal (GI) tract, regardless of the type of wound classified by the Center for Disease Control (CDC). The COVER trial is a multicenter, randomized controlled clinical trial with two parallel arms – one using a wound protector and the other using conventional surgical dressing gauze. The primary outcome will measure the rate of SSI in two groups. Statistical analysis of the primary end point will be based on the intention-to-treat population. The sample size is determined to achieve a study power of 80% at 95% 2-sided confidence limits. Considering a dropout rate of up to 5%, a total of 458 patients, 229 patients in each group, will be enrolled in this study. Discussion: The COVER trial will provide high-quality evidence for using a circular polyethylene drape in open abdominal surgery for the GI tract in all types of wound. The design of the trial will deliver high external validity and clinical significance. Trial registration: The trial protocol was registered at ClinicalTrials.gov (NCT 03170843) on May 31, 2017. https://clinicaltrials.gov/ct2/show/NCT03170843?term=NCT+03170843&rank=1 Keywords: Circular polyethylene drape, Abdominal surgery, Gastrointestinal tract, Surgical site infection, Randomized controlled trial

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