The Effects on Fluid Balance and Renal Function Using a Restrictive Fluid Strategy in the Postoperative Setting in Patients With Low Urinary Output Undergoing Pancreatic Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Ringer's Acetate
- Conditions
- Fluid Therapy
- Sponsor
- Uppsala University
- Enrollment
- 53
- Locations
- 1
- Primary Endpoint
- Urinary output
- Status
- Terminated
- Last Updated
- 3 years ago
Overview
Brief Summary
Reduced urinary output is a common postoperative issue for patients going through major surgery such as pancreatic surgery. Commonly this is treated by increasing fluid administration to the patients and sometimes also diuretics. However, overloading patients with fluid also have several risks and known complications. Studies have also shown that a short period of decreased urinary output in the postoperative period do not have an increased incidence of acute renal failure. The aim of our study is to investigate the difference in renal function and postoperative complications associated with fluid overload on these patients that are randomized to either receiving a fluid bolus directly when urinary output decreases or to await for a maximum of four hours to see if urinary output increases spontaneously.
Detailed Description
Patents after pancreatic surgery will be included in the study. Oliguric patients (urine output \<0.5 ml/kg/h) will be randomized to fluid bolus (5ml/kg Ringer's Acetate in 30 minutes) or no intervention. Primary outcome is difference in urine output two hours after the fluid bolus or no intervention.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients going through pancreatic surgery.
Exclusion Criteria
- •If not oliguric (urinary output \<0,5 mls/kg/h) during their stay in the postoperative department
- •Hemodynamic instability (the need for \>0,1 microgram/kg/min of norepinephrine to keep an acceptable mean arterial pressure based on the patients starting mean arterial pressure).
- •Patients that do not want to be a part of the study.
- •\<18 years old
Arms & Interventions
Standard of care group
Will receive a fluid bolus 5 ml/kg Ringer's Acetate infusion immediately if oliguric/anuric for two consecutive hours (standard of care).
Intervention: Ringer's Acetate
Outcomes
Primary Outcomes
Urinary output
Time Frame: 2 hours
Difference in urinary output two hours after giving the patient a fluid bolus (Control Group) or awaiting fluid bolus (interventional Group)..
Secondary Outcomes
- Renal function(48 hours)
- Cumulative fluid balance(48 hours)
- Postoperative complications(90 days)
- Mortality(90 days)
- Vasopressin (ADH)(1 day)
- Renal replacement therapy(Up to 90 days)
- Inotropy(1 week)
- S-osmolality(1 day)