Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction
ObjectiveThe maintenance of low central venous pressure (CVP) during hepatic resection is associated with a reduction in estimated blood loss. After completion of the hepatic parenchymal transection, fluid is rapidly administered to replace the surgical blood loss and fluid deficit to prevent subseq...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036850/full |
| _version_ | 1811226107890892800 |
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| author | Jungho Shin Suk-Won Suh |
| author_facet | Jungho Shin Suk-Won Suh |
| author_sort | Jungho Shin |
| collection | DOAJ |
| description | ObjectiveThe maintenance of low central venous pressure (CVP) during hepatic resection is associated with a reduction in estimated blood loss. After completion of the hepatic parenchymal transection, fluid is rapidly administered to replace the surgical blood loss and fluid deficit to prevent subsequent organ injury risk. However, this perioperative fluid strategy may influence on the postoperative outcomes of patients with left ventricular diastolic dysfunction (LVDD) who cannot tolerate volume adjustment.MethodA total of 206 patients with who underwent hepatic resection between March 2015 and February 2021 were evaluated. LVDD was defined according to the American Society of Echocardiography and the European Association of Cardiovascular Imaging 2016 recommendations as LVDD (group A, n = 39), or normal LV diastolic function and indeterminate decision (group B, n = 153). We compared the clinical outcomes of patients between two groups, and then analyzed the risk factors for postoperative complications.ResultPostoperative acute kidney injury (AKI, 10.3% vs. 1.3%, P = 0.004) and pleural effusion or edema (51.3% vs. 30.1%, P = 0.013) were more common in group A than in group B. Further, creatinine levels from postoperative day 1 to day 7 were significantly higher and daily urine outputs at postoperative day 1 (P = 0.038) and day 2 (P = 0.025) were significantly lower in group A than in group B. LVDD was the only significant risk factor for postoperative AKI after hepatic resection (odds ratio, 10.181; 95% confidence interval, 1.570–66.011, P = 0.015).ConclusionsThe rates of renal dysfunction and pulmonary complications after hepatic resection are higher in patients with LVDD than in those with normal LV diastolic function. Thus, these patients require individualized fluid management. |
| first_indexed | 2024-04-12T09:18:44Z |
| format | Article |
| id | doaj.art-e1f30392509149fa8febb82a5163aeff |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T09:18:44Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-e1f30392509149fa8febb82a5163aeff2022-12-22T03:38:45ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-11-01910.3389/fsurg.2022.10368501036850Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunctionJungho Shin0Suk-Won Suh1Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, KoreaDepartment of Surgery, College of Medicine, Chung-Ang University, Seoul, KoreaObjectiveThe maintenance of low central venous pressure (CVP) during hepatic resection is associated with a reduction in estimated blood loss. After completion of the hepatic parenchymal transection, fluid is rapidly administered to replace the surgical blood loss and fluid deficit to prevent subsequent organ injury risk. However, this perioperative fluid strategy may influence on the postoperative outcomes of patients with left ventricular diastolic dysfunction (LVDD) who cannot tolerate volume adjustment.MethodA total of 206 patients with who underwent hepatic resection between March 2015 and February 2021 were evaluated. LVDD was defined according to the American Society of Echocardiography and the European Association of Cardiovascular Imaging 2016 recommendations as LVDD (group A, n = 39), or normal LV diastolic function and indeterminate decision (group B, n = 153). We compared the clinical outcomes of patients between two groups, and then analyzed the risk factors for postoperative complications.ResultPostoperative acute kidney injury (AKI, 10.3% vs. 1.3%, P = 0.004) and pleural effusion or edema (51.3% vs. 30.1%, P = 0.013) were more common in group A than in group B. Further, creatinine levels from postoperative day 1 to day 7 were significantly higher and daily urine outputs at postoperative day 1 (P = 0.038) and day 2 (P = 0.025) were significantly lower in group A than in group B. LVDD was the only significant risk factor for postoperative AKI after hepatic resection (odds ratio, 10.181; 95% confidence interval, 1.570–66.011, P = 0.015).ConclusionsThe rates of renal dysfunction and pulmonary complications after hepatic resection are higher in patients with LVDD than in those with normal LV diastolic function. Thus, these patients require individualized fluid management.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036850/fullleft ventricular diastolic dysfunctionfluid balanceacute kidney injurypulmonary edema or effusionhepatic resection |
| spellingShingle | Jungho Shin Suk-Won Suh Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction Frontiers in Surgery left ventricular diastolic dysfunction fluid balance acute kidney injury pulmonary edema or effusion hepatic resection |
| title | Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| title_full | Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| title_fullStr | Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| title_full_unstemmed | Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| title_short | Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| title_sort | influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction |
| topic | left ventricular diastolic dysfunction fluid balance acute kidney injury pulmonary edema or effusion hepatic resection |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036850/full |
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