Key result
Correction of postoperative hypotension with crystalloid infusion therapy and noradrenaline increased the risk of pneumonia and complication severity compared to noradrenaline alone.
Why the study?
Whether crystalloid solutions are appropriate for arterial hypotension in patients undergoing extensive scheduled thoracic operations is undefined.
Does noradrenaline alone compared to noradrenaline with infusion therapy reduce postoperative complications in patients with hypotension following thoracic surgery?
Observational (n=154)
Does noradrenaline alone compared to noradrenaline with infusion therapy reduce postoperative complications in patients with hypotension following thoracic surgery?
In patients with postoperative hypotension after thoracic surgery, using noradrenaline alone rather than combining it with crystalloid infusion may reduce the risk of pneumonia and overall complication severity.
Crystalloid correction of post-thoracic surgery hypotension was associated with higher pneumonia and complication rates; leaves open optimal vasopressor strategy.
Introduction Arterial hypotension is the reasonable cause for intravenous injections of crystalloid solutions. However, as far as this statement is fair in the patients that underwent extensive scheduled thoracic operations at that moment is not defined. Aim To reduce the number of complications in patients following thoracic operations by definition of optimum strategy for correction of postoperative hypotension. Methods The retrospective analysis of 154 patients who were divided into 2 groups was conducted. In 58 patients, for correction of arterial blood pressure we used noradrenaline, in other cases (96 patients) noradrenaline in combination with infusion therapy was administered. The comparative analysis of the perioperative volemic status, levels of hemoglobin, urea, creatinine, a lactate, glucose, paO2 , paCO2 , ScvO2 , SaO2 , pvCO2 -paCO2 , duration of noradrenaline application and also a range of the postoperative complications was carried out. Results and conclusions It is revealed that correction of hypotension with crystalloid solutions in thoracic patients results at and conclusions increased risk of pneumonia development. At the same time, infusion therapy in the early postoperative period in thoracic patients did not reduce the risk of intense kidney failure development. Severity of postoperative complications according to Clavien-Dindo classification was higher in patients who had infusion therapy. At the same time, duration of vasopressor support showed no change.
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Zhikharev et al. (2019) conducted an observational in Postoperative hypotension following thoracic operations (n=154). Noradrenaline in combination with infusion therapy (crystalloid solutions) vs. Noradrenaline alone was evaluated on Postoperative complications including pneumonia, kidney failure, and severity according to Clavien-Dindo classification. Correction of postoperative hypotension with crystalloid infusion therapy and noradrenaline increased the risk of pneumonia and complication severity compared to noradrenaline alone.
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