Acute Kidney Injury, Acute Respiratory Failure Requiring Reintubation, Hypoxia, Pneumonia, Pulmonary Edema, Respiratory Failure
Conditions
Keywords
Fluids, Intraoperative, Respiratory, Outcomes, Surgery, Anesthesia
Brief summary
Intraoperative intravenous fluid management practice varies greatly between anesthesiologists. Postoperative fluid based weight gain is associated with major morbidity. Postoperative respiratory complications are associated with increased morbidity, mortality and hospital costs. The literature shows conflicting data regarding intraoperative fluid resuscitation volume. No large-scale studies have focused on intraoperative fluid management and postoperative respiratory dysfunction. Hypotheses: Primary - Liberal intraoperative fluid resuscitation is associated with an increased risk of 30 day mortality Secondary - Liberal intraoperative fluid resuscitation is associated with increased likelihood of postoperative respiratory failure, pulmonary edema, reintubation, atelectasis, acute kidney injury and peri-extubation oxygen desaturation.
Interventions
None listed
Sponsors
Massachusetts General Hospital
Study design
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Ages 18 upwards * Tracheally intubated at the beginning of the procedure and extubated at the end of the procedure
Exclusion criteria
* Cases where the subject had additional surgeries within the previous four weeks * Ages under 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | within 30 days after surgery | Mortality within 30 days of surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pulmonary complications | 3 days after surgery | The incidence of a diagnosis of pneumonia, respiratory failure, atelectasis or pulmonary edema within 3 days after extubation in the operating room. Cases where these diagnoses were present on the day before surgery were not counted. |
| Acute Kidney Injury | within 48 hours of surgery | A Creatinine increase of \>0.3mg/dl or 50% from baseline (Creatinine value closest recorded to surgery but within 30 days of surgery) to maximum value measured within 48 hours postoperatively or an ICD-9 diagnosis of AKI within 7 days of surgery but not within 30 days prior to surgery |
| Post-extubation oxygen desaturation | within the first 10 minutes after extubation | One or more minutes with a blood oxygen saturation below 90% during the first ten minutes after extubation |
Countries
United States
Outcome results
None listed