Intraoperative Fluid Therapy-Finding a Balance:A single centre Experience With Restricted Fluid Therapy In Adult Living Donor Liver Transplant
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 400
- 试验地点
- 1
- 主要终点
- 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.
研究概览
简要总结
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 (December 2022- November 2023) 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. Patients who underwent living donor liver transplant from December 2021 to November 2022 received intraoperative fluids as per conventional fluid therapy and will be used as control group for comparative analysis.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 70.00 Year(s)（—）
- 性别
- All
入选标准
- •All patients over 18years of age undergoing adult living donor liver transplant from December 2021 to November 2023 will be enrolled in the study.
排除标准
- •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.
结局指标
主要结局
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.
时间窗: 72 hours
•Incidence of Acute kidney injury within 72 hours postoperatively. Need for renal replacement therapy.
时间窗: 72 hours
次要结局
- 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)