Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/26509
Title: Restrictive versus Standard Fluid Regimen in Elective Minilaparotomy Abdominal Aortic Repair-Prospective Randomized Controlled Trial
Authors: Piljic, Dragan
Petricevic, Mate
Piljic, Dilista
Ksela, Jus
ROBIC, Boris 
Klokocovnik, Tomislav
Issue Date: 2016
Source: THORACIC AND CARDIOVASCULAR SURGEON, 64(4), p. 296-303
Abstract: Objective Elective minilaparotomy abdominal aortic aneurysm (AAA) repair is associated with a significant number of complications involving respiratory, cardiovascular, gastrointestinal, and central nervous systems, with mortality ranging up to 5%. In our study, we tested the hypothesis that intra-and postoperative intravenous restrictive fluid regimen reduces postoperative morbidity and mortality, and improves the outcome of minilaparotomy AAA repair. Methods From March 2009 to July 2013, 60 patients operated due to AAA were included in a prospective randomized controlled trial (RCT). About the administration of fluid during the operation and in the early postoperative period, all the patients were randomized into two groups: the group of standard fluid administration (S-group, 30 patients) and the group of reduced fluid administration (R-group, 30 patients). The verification of the treatment success was measured by the length of intensive care unit (ICU) stay, duration of hospitalization after the procedure, as well as the number and type of postoperative complications and mortality. This prospective RCT was registered in a publicly accessible database ClinicalTrials.gov with unique Identifier ID: NTC01939652. Results Total fluid administration and administration of blood products were significantly lower in R-group as compared with S-group (2,445.5 mL vs. 3308.7 mL, p = 0.004). Though the number of nonlethal complications was significantly lower in R-group (2 vs. 9 patients, p 0.042), the difference in lethal complications remained nonsignificant (0 vs. 1 patient, p ns). The average ICU stay (1.2 vs. 1.97 days, p = 0.003) and duration of postoperative hospital stay (4.33 vs. 6.20 days, p 0.035 for R-group and S-group, respectively) were found to be significantly shorter in R-group. Conclusion Intra-and postoperative restrictive intravenous fluid regimen in patients undergoing minilaparotomy AAA repair significantly reduces postoperative morbidity, and shortens ICU and overall hospital stay. Even though incidence of lethal complication was lower in R-group, the difference did not reach statistical significance. Therefore, we may assume that this study was probably underpowered to estimate the differences in mortality between R-and S-groups. Further multicentric, sufficiently powered RCTs are needed to confirm these findings and to clarify effect of restrictive fluidmanagement on mortality.
Keywords: aneurysm; aorta/aortic; blood transfusion
Document URI: http://hdl.handle.net/1942/26509
ISSN: 0171-6425
e-ISSN: 1439-1902
DOI: 10.1055/s-0035-1548736
ISI #: 000377477800005
Rights: © Georg Thieme Verlag KG Stuttgart · New York
Category: A1
Type: Journal Contribution
Appears in Collections:Research publications

Files in This Item:
File Description SizeFormat 
petricevic2015.pdfPublished version161.57 kBAdobe PDFView/Open
Show full item record

SCOPUSTM   
Citations

6
checked on Sep 3, 2020

WEB OF SCIENCETM
Citations

12
checked on Mar 21, 2024

Page view(s)

80
checked on Sep 7, 2022

Download(s)

318
checked on Sep 7, 2022

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.