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Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections

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dc.contributor.authorKARARMAZ, ALPER
dc.contributor.authorsArslantas, Mustafa Kemal; Kara, Hasan Volkan; Tuncer, Beliz Bilgili; Yildizeli, Bedrettin; Yuksel, Mustafa; Bostanci, Korkut; Bekiroglu, Nural; Kararmaz, Alper; Cinel, Ismail; Batirel, Hasan F.
dc.date.accessioned2022-03-14T11:08:01Z
dc.date.available2022-03-14T11:08:01Z
dc.date.issued2015-01
dc.description.abstractObjective: Excessive fluid administration during lung resections is a risk for pulmonary injury. We analyzed the effect of intraoperative fluids on postoperative pulmonary complications (PCs). Methods: Patients who underwent anatomic pulmonary resections during 2012 to 2013 were included. Age, weight, pulmonary function data, smoking (pack-years), the infusion rate and the total amount of intraoperative fluids (including crystalloid, colloid, and blood products), duration of anesthesia, hospital stay, PCs, and mortality were recorded. PCs were defined as acute respiratory distress syndrome, need for intubation, bronchoscopy, atelectasis, pneumonia, prolonged air leak, and failure to expand. Univariate analyses and multivariate logistic regression were performed. A Lowess curve was drawn for intraoperative fluid threshold. Results: In 139 patients, types of resections were segmentectomy-lobectomy (n = 69; extended n = 37; video-assisted thoracoscopic surgery n = 19) and pneumonectomy (n = 9; extended n = 5). One hundred sixty-one PCs were observed in 76 patients (acute respiratory distress syndrome [n = 5], need for intubation [n = 9], atelectasis [n = 60], need for bronchoscopy [n = 19], pneumonia [n = 26], prolonged air leak [n = 19], and failure to expand [n = 23]). Overall mortality was 4.3% (6 out of 139 patients). Mean hospital stay was 8.5 +/- 4.8 days. Univariate analyses showed that smoking, intraoperative total amount of fluids, crystalloids, blood products, and infusion rate as well as total amount of crystalloids and infusion rate during the postoperative first 48 hours were significant for PCs (P = .033, P < .0001, P = .001, P = .03, P < .0001, P = .002, and P < .0001, respectively). In multivariate logistic regression analysis intraoperative infusion rate (P < .0001) and smoking were significant (P = .023). An infusion rate of 6 mL/kg/h was found to be the threshold. Conclusions: The occurrence of postoperative PCs is seen more frequently if the intraoperative infusion rate of fluids exceeds 6 mL/kg/h.
dc.identifier.doi10.1016/j.jtcvs.2014.08.071
dc.identifier.eissn1097-685X
dc.identifier.issn0022-5223
dc.identifier.pubmed25304302
dc.identifier.urihttps://hdl.handle.net/11424/245937
dc.identifier.wosWOS:000350550100086
dc.language.isoeng
dc.publisherMOSBY-ELSEVIER
dc.relation.ispartofJOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectRESPIRATORY-DISTRESS-SYNDROME
dc.subjectTHORACIC-SURGERY
dc.subjectRISK-FACTORS
dc.subjectINJURY
dc.subjectMANAGEMENT
dc.subjectMORTALITY
dc.subjectCANCER
dc.subjectMORBIDITY
dc.subjectTHERAPY
dc.subjectIMPACT
dc.titleEffect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections
dc.typearticle
dspace.entity.typePublication
local.avesis.idf0f57bc0-2fa3-41c1-b691-e9cc8b1466d9
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages8
oaire.citation.endPage+
oaire.citation.issue1
oaire.citation.startPage314
oaire.citation.titleJOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
oaire.citation.volume149
relation.isAuthorOfPublication82a34ee2-92e5-4f63-a34a-297f183aa79b
relation.isAuthorOfPublication.latestForDiscovery82a34ee2-92e5-4f63-a34a-297f183aa79b

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