High intraoperative fluid load associated with prolonged length of hospital stay and complications after non-cardiac surgery in neonates

作者：Minyue Qian, Jialian Zhao, Kai Zhang, Wenyuan Zhang, Chunyi Jin, Binbin Cai, Zhongteng Lu, Yaoqin Hu, Jinjin Huang, Daqing Ma, Xiangming Fang, Yue Jin · 发表于：European Journal of Pediatrics · 年份：2024 · DOI：10.1007/s00431-024-05628-x · 被引用次数：4 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Hemodynamic Monitoring and Therapy、Abdominal Surgery and Complications

Abstract Inappropriate perioperative fluid load can lead to postoperative complications and death. This retrospective study was designed to investigate the association between intraoperative fluid load and outcomes in neonates undergoing non-cardiac surgery. From April 2020 to September 2022, 940 neonates who underwent non-cardiac surgery were retrospectively enrolled and their perioperative data were harvested for further analysis. According to recorded intraoperative fluid volumes defined as ml.kg −1 h −1 , patients were mandatorily divided into quintile with fluid load as restrictive (quintile 1, Q1), moderately restrictive (Q2), moderate (Q3), moderately liberal (Q4), and liberal (Q5). The primary outcomes were defined as prolonged length of hospital stay (LOS) (postoperative LOS ≥ 14 days), complications beyond prolonged LOS, and 30-day mortality. Secondary outcomes included postoperative complications within 14 days of hospital stay. The intraoperative fluid load was in Q1 of 6.5 (5.3–7.3) (median and IQR); Q2: 9.2 (8.7–9.9); Q3: 12.2 (11.4–13.2); Q4: 16.5 (15.4–18.0); and Q5: 26.5 (22.3–32.2) ml.kg −1 h −1 . The odd of prolonged LOS was positively correlated with an increase fluid volume (Q5 quintile: OR 2.602 [95% CI 1.444–4.690], P = 0.001), as well as complications beyond prolonged LOS (Q5: OR 3.322 [95% CI 1.656–6.275], P = 0.001). The overall 30-day mortality rate was increased with high intraoperative fluid load but did not reach to a statistical significance aft...