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The significance of cumulative water balance in the development of early complications after major abdominal surgery


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The aim: a comprehensive assessment of the water balance on the basis of daily, cumulative balance and 10% of the body weight gain and their role in the development of early complications after major abdominal surgery. Materials and methods: A retrospective study of the perioperative period in 150 patients who underwent major abdominal surgery was performed. The physical condition of the patients corresponded to ASA 3 class. The average age was 46 (38-62) years. The following stages of research: an analysis of daily balance and cumulative balance in complicated and uncomplicated group and their role in the development of complications; the timing of development of complications and possible relationship with fluid overload and the development of complications; changes in the level of albumin within 10 days of the postoperative period. Results: The analysis of complications didn t show significant differences between complicated and uncomplicated groups according to the water balance during the surgery and by the end of the first day. When constructing the area under the ROC curve (AUROC) low resolution of the balance in intraoperative period and the first day and the balance on the second day to predict complications was shown. Significant differences according to the cumulative balance was observed from the third day of the postoperative period. Also with the third day of the postoperative period there is a good resolution for prediction of postoperative complications according to the cumulative balance with the cut-off point > of 50,7ml/kg. Conclusion: the excessive infusion therapy is a predictor of adverse outcome in patients after major abdominal surgery. Therefore, after 3 days ofpostoperative period it is important to maintain mechanisms for the excretion of excess fluid or limitations of infusion therapy.

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