Intraoperative Fluid Therapy-Finding A Balance: A Single Centre Experience With Restrictive Fluid Therapy In Adult Living Donor Liver Transplant
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Dr Amit Singhal
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- •Incidence of Acute kidney injury within 72 hours postoperatively. Need for renal replacement therapy.
Overview
Brief Summary
We practice weight based restrictive fluid strategy with maintenance therapy at 4ml/kg/h (2ml/kg/h crystalloids + 2ml/kg/h 4%albumin solution) and fluid boluses guided by goal directed parameters.We will retrospectively analyze our data of patients undergoing adult living donor liver transplant in one year period and determine the average fluid requirement and its effect on pulmonary outcomes and incidence of postoperative acute kidney injury. Secondary outcomes will be intraoperative blood and vasopressor requirement(noradrenaline) and vascular complication rate.We hypothesise that our strategy of continuous maintenance therapy with intermittent fluid boluses improves pulmonary outcomes with no increased risk of acute kidney injury. The statistical analysis will be done with the Graph Pad Prism.
Study Design
- Study Type
- Observational
Eligibility Criteria
- Ages
- 18.00 Year(s) to 75.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •All patients over 18years of age undergoing adult living donor liver transplant from December 2022 to November 2023 will be enrolled in the study.
Exclusion Criteria
- •Patients less than 18years of age.
- •Patients with H/O recent (less than one week) Hepatorenal syndrome/Acute Kidney Injury.
- •Patients with known H/O chronic kidney disease.
- •Patients with Hepatopulmonary syndrome/Portopulmonary Hypertension.
- •Combined procedure with liver transplant.
- •H/O hepatic encephalopathy (Grade 2 or more at the time of transplant).
- •Patients with acute liver failure. INTRAOPERATIVE-.
- •Patients requiring intraoperative continuous renal replacement therapy.
- •Patients with incomplete data POSTOPERATIVE.
- •Patient requiring mechanical ventilation for graft dysfunction or neurological complications.
Outcomes
Primary Outcomes
•Incidence of Acute kidney injury within 72 hours postoperatively. Need for renal replacement therapy.
Time Frame: 72 hours
•Evaluate our rate of early extubation (on-table extubation, extubated within 4hours postoperatively) after living donor liver transplant, mean duration of mechanical ventilation, pulmonary complications such as pulmonary edema , pleural effusion requiring drainage within 72 hours postoperatively.
Time Frame: 72 hours
Secondary Outcomes
- Intraoperative need for packed red blood cells, vasopressor requirement (noradrenaline-mcg/kg/min and total vasopressin units) and rate of vascular complications (hepatic artery thrombosis)(Intraoperative period)
Investigators
Dr Amit Singhal
BLK Max Superspeciality Hospital