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Tytuł pozycji:

The Influence of Perioperative Fluid Therapy on N-terminal-pro-brain Natriuretic Peptide and the Association With Heart and Lung Complications in Patients Undergoing Colorectal Surgery: Secondary Results of a Clinical Randomized Assessor-blinded Multicenter Trial.

Tytuł :
The Influence of Perioperative Fluid Therapy on N-terminal-pro-brain Natriuretic Peptide and the Association With Heart and Lung Complications in Patients Undergoing Colorectal Surgery: Secondary Results of a Clinical Randomized Assessor-blinded Multicenter Trial.
Autorzy :
Brandstrup B; Department of Surgery, Holbæk Hospital, Holbæk, Denmark.
Beier-Holgersen R; Department of Surgery, Nordsjællands Hospital Hillerød, Hillerød, Denmark.
Iversen LH; Department of Surgery, Aahus University Hospital, Aarhus C, Denmark.
Starup CB; Niels Bohr Institute, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
Wentzel LN; Niels Bohr Institute, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
Lindorff-Larsen K; NordSim, Aalborg University Hospital, Aalborg, Denmark.
Petersen TC; Niels Bohr Institute, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
Tønnesen H; WHO-CC, Bispebjerg-Frederiksberg Hospital, Copenhagen University, Frederiksberg, Denmark.
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Źródło :
Annals of surgery [Ann Surg] 2020 Dec; Vol. 272 (6), pp. 941-949.
Typ publikacji :
Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Język :
Imprint Name(s) :
Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
MeSH Terms :
Fluid Therapy*
Colonic Diseases/*blood
Colonic Diseases/*surgery
Heart Diseases/*epidemiology
Lung Diseases/*epidemiology
Natriuretic Peptide, Brain/*blood
Peptide Fragments/*blood
Postoperative Complications/*epidemiology
Rectal Diseases/*blood
Rectal Diseases/*surgery
Aged ; Colonic Diseases/therapy ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period ; Rectal Diseases/therapy ; Single-Blind Method
References :
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Molecular Sequence : NCT03537989
Substance Nomenclature :
0 (Peptide Fragments)
0 (pro-brain natriuretic peptide (1-76))
114471-18-0 (Natriuretic Peptide, Brain)
Entry Date(s) :
Date Created: 20191219 Date Completed: 20210223 Latest Revision: 20210223
Update Code :
Czasopismo naukowe
Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-terminal-pro-brain natriuretic peptide (NT-Pro-BNP) in colorectal surgical patients and its association with cardiopulmonary complications (CPC). In addition, to examine if preoperative NT-Pro-BNP can predict the risk for postoperative CPC.
Methods: Blood samples from patients enrolled in a previously published clinical randomized assessor-blinded multicenter trial were analyzed. Included were adult patients undergoing elective colorectal surgery with the American-Society-of-Anesthesiologists-scores of 1-3. Samples from 135 patients were available for analysis. Patients were allocated to either a restrictive (R-group) or a standard (S-group) iv-fluid regimen, commencing preoperatively and continuing until discharge. Blood was sampled every morning until the fourth postoperative day. The primary outcome for this study was NT-Pro-BNP changes and its association with fluid therapy and CPC.
Results: The S-group received more iv-fluid than the R-group on the day-of-surgery [milliliter, median (range) 6485 (4401-10750) vs 3730 (2250-8510); P < 0.001] and on the first postoperative day. NT-Pro-BNP was elevated in the S-group compared with the R-group on all postoperative days [area under the curve: median (interquartile range) pg/mL: 3285 (1697-6179) vs 1290 (758-3719); P < 0.001 and in patients developing CPC vs no-CPC (area under the curve), median (interquartile range): 5196 (1823-9061) vs 1934 (831-5301); P = 0.005]. NT-pro-BNP increased with increasing fluid volumes all days (P < 0.003). Preoperative NT-Pro-BNP predicted CPC [odds ratio (confidence interval): 1.573 (0.973-2.541), P = 0.032; positive predictive value = 0.257, negative predictive value = 0.929].
Conclusions: NT-pro-BNP increases with iv-fluid volumes given to colorectal surgical patients, and the level of NT-Pro-BNP is associated with CPC. Preoperative NT-Pro-BNP is predictive for CPC, but the diagnostic value is NCT03537989.

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