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Eur J Pediatr Surg 2020; 30(02): 187-192
DOI: 10.1055/s-0038-1677544
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Crystalloid Administration Is Associated with the Recovery of Pediatric Elective Roux-en-Y Hepaticojejunostomy

Xingqin Tan
1   Department of Anesthesiology, Children's Hospital, Chongqing Medical University, Chongqing, China
2   Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, China
,
Jianxia Liu
1   Department of Anesthesiology, Children's Hospital, Chongqing Medical University, Chongqing, China
2   Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, China
,
Chunbao Guo
2   Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, China
3   Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, China
› Author Affiliations
Funding This study was funded by grants from the National Natural Science Foundation of China (No: 30973440, 30770950) and the key project of the Chongqing Natural Science Foundation (CSTC, 2008BA0021, cstc2012jjA0155).
Further Information

Publication History

31 July 2018

13 December 2018

Publication Date:
21 January 2019 (online)

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Abstract

Introduction Intraoperative fluid administration is important for postoperative recovery and might be associated with postoperative complications.

Materials and Methods This retrospective review included 471 patients who underwent Roux-en-Y hepaticojejunostomy. Patients were separated into two groups based on whether they received low (<15.27 mL/kg/h) or high (>15.27 mL/kg/h) volumes of corrected crystalloid fluids. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 192 matched patients, clinical outcomes, including postoperative complications and length of hospital stay, were compared.

Results Higher use of diuresis (p = 0.027) was found in the high fluid group. Receiving low volumes of crystalloids was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.31–1.07; p = 0.047) and first bowel movement (OR, 0.56; 95% CI, 0.38–0.98; p = 0.013). However, the occurrence of renal complications did not show significant differences between the groups. A lower postoperative complication rate (OR, 0.54; 95% CI, 0.42–0.94; p = 0.016) was noted in patients with low crystalloids compared with high crystalloids. The total length of hospital stay was longer in patients with high crystalloid fluid (9.21 ± 3.24 days) than patients with low volumes (7.83 ± 2.58 days; p = 0.012).

Conclusion Low crystalloid fluid administration was associated with favorable postoperative outcomes.

Keywords

crystalloid administration - length of hospital stay - abdominal surgery - acute kidney injury

Authors' Contributions

X.T. designed and analyzed the data and evaluated the article. J.L. performed the statistical measurements and analyzed the data. C.G. analyzed the data and wrote the article.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.