دورية أكاديمية
Pre-operative fluid resuscitation in the emergency general surgery septic patient: does it really matter?
| العنوان: | Pre-operative fluid resuscitation in the emergency general surgery septic patient: does it really matter? |
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| المؤلفون: | Benjamin Moran, Erin Major, Joseph A. Kufera, Samuel A. Tisherman, Jose Diaz |
| المصدر: | BMC Emergency Medicine, Vol 21, Iss 1, Pp 1-9 (2021) |
| بيانات النشر: | BMC, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Special situations and conditions LCC:Medical emergencies. Critical care. Intensive care. First aid |
| مصطلحات موضوعية: | Emergency general surgery, Abdominal Sepsis, Fluid resuscitation, Source control, Pre-operative resuscitation, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| الوصف: | Abstract Objective Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends a 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. The optimal amount of pre-operative fluid resuscitation prior to source control in patients with intra-abdominal sepsis is unknown. This study aims to determine if increasing volume of resuscitation prior to surgical source control is associated with worsening outcomes. Methods We conducted an 8-year retrospective chart review of EGS patients undergoing surgery for abdominal sepsis within 24 h of admission. Patients in hemorrhagic shock and those with outside hospital index surgeries were excluded. We grouped patients by increasing pre-operative resuscitation volume in 10 ml/kg intervals up to > 70 ml/kg and later grouped them into 30 ml/kg (p = 0.02). These groups had median qSOFA scores (1.0 vs. 1.0, p = 0.06). There were no differences in time to operation (6.1 vs 4.9 h p = 0.11), ventilator days (1 vs 3, p = 0.08), or hospital LOS (8 vs 9 days, p = 0.57). Relative risk regression correcting for age and physiologic factors showed no significant differences in mortality between the fluid groups. Conclusions Greater pre-operative resuscitation volumes were initially associated with significantly higher mortality, despite similar organ failure scores. However, fluid volumes were not associated with mortality following adjustment for other physiologic factors in a regression model. The amount of pre-operative volume resuscitation was not associated with differences in time to operation, ventilator days, ICU or hospital LOS. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1471-227X |
| Relation: | https://doaj.org/toc/1471-227X |
| DOI: | 10.1186/s12873-021-00479-3 |
| URL الوصول: | https://doaj.org/article/22896a65e1524a04a92856cdbad63294 |
| رقم الأكسشن: | edsdoj.22896a65e1524a04a92856cdbad63294 |
| قاعدة البيانات: | Directory of Open Access Journals |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1471227X |
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| DOI: | 10.1186/s12873-021-00479-3 |