Cumulative fluid balance in the postoperative period of abdominal surgery

Abstract

Materials and methods. To analyze the volumes of administered and removed fluid, fluid balance, cumulative fluid balance during 5 days and its relationship with mortality in 143 patients after abdominal surgical interventions who were treated in the department of anesthesiology and intensive care. Two groups of patients were identified: 1st (n = 86) - without sepsis, 2nd (n = 57) - with the presence of sepsis. There were no deaths in group 1, 11 patients (19.3%) died in group 2.Results. The patients of the 2nd group had a positive fluid balance in the volume of 1.55 (1.2; 2.4) liters on the first day, which was significantly greater than in the patients of the 1st group - 1.1 (0.4; 1.8) liters (p = 0.0016). At the subsequent stages, the fluid balance in patients in the studied groups did not differ. The optimal limits for maintaining the cumulative fluid balance during 5 days in patients of the 2nd group in the postoperative period of surgical interventions were established: less than 5.6 liters or less than 8 % of the patient’s body weight. Exceeding the 5-day cumulative fluid balance above 5.6 liters or more than 8 % of body weight resulted in a significant increase in the risk of mortality among patients in group 2: odds ratio (OR) - 1.39 (p < 0.01) and 1.24 (p < 0.01), respectively.Conclusion. The features of fluid balance in patients with sepsis in the postoperative period of abdominal surgical interventions are highlighted.